LYNN GILLIAN-NOWAK (NPI# 1962748624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962748624 |
Entity Type | Individual |
Full Name | LYNN GILLIAN-NOWAK |
Credential | LPC, CSAC |
Practice Address |
1519 E Washington St Ste A West Bend WI 53095-2615 |
Practice Telephone | 2623059668 |
Practice Fax Number | 2624160085 |
Mailing Telephone | 2623059668 |
Mailing Fax Number | 2624160085 |
Enumeration Date | 2012-12-27 |
Last Update Date | 2020-11-02 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
15917-132 | WI | Behavioral Health & Social Service Providers |
Y | 101YP2500X |
Counselor Specialization: Professional |
6584-125 | WI | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 100027556 | 05 | |
WI | 1962748624 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
11512 W Port Washington Rd, Suite 201e, Mequon, WI 53092 | 2623059668 | |
121 W Main St, Port Washington, WI 530741813 | 2622848157 | |
1228 Highway 33, West Bend, WI 53095 | 2623059668 | 2624160085 |
Street Address |
1519 E WASHINGTON ST STE A |
City | WEST BEND |
State | WI |
Zip Code | 53095-2615 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609355452 | Lakeshore Wellness and Recovery Inc | Counselor | 1519 E Washington St Ste A, West Bend, WI 53095-2615 | 2018-08-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942820428 | David Fountain | Contractor | 726 Creedwood Lane, West Bend, WI 53095 | 2020-04-24 |
1922664358 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1745 South Main St, West Bend, WI 53095 | 2019-05-10 |
1912423773 | Michelle R Prentice | Family Medicine | West Bend Health Center, 1700 W. Paradise Drive, West Bend, WI 53095 | 2017-08-14 |
1386165918 | Quad/med, LLC | Clinic/Center | 432 E. Washington St. #1115, West Bend, WI 53095 | 2017-07-05 |
1508230632 | Jesen Daniel | Counselor | 111 East Washington St, Affiliated Clinical Services, West Bend, WI 53095 | 2015-12-01 |
1477965259 | Jenna Crofts | Specialist/Technologist | 1190 East Paradise Drive, West Bend, WI 53095 | 2014-05-28 |
1023436342 | Visionworks | Optometrist | 1437 S. Main St., West Bend, WI 53095 | 2014-04-03 |
1295157295 | Stephanie Rabe | Registered Nurse | 910 E. Paradise Drive, West Bend, WI 53095 | 2014-01-09 |
1477898815 | Ralph Norman Olsen | Pediatrics | 6267 Riesch Road, West Bend, WI 53095 | 2012-12-11 |
1932458536 | Joshua Aaron Barta | Dentist | 2090 Continental Drive, West Bend, WI 53095 | 2012-08-29 |
Find all providers in zip 53095 |
Taxonomy Code | 101YP2500X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Professional |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891286043 | Rebekah Lynn Wolff | Counselor | 400 W River Road, West Bend, WI 53090 | 2018-05-23 |
1295104297 | Suzanne Kordas | Counselor | 8878 Orchard Valley Rd, West Bend, WI 53090-9032 | 2015-09-20 |
1700151636 | Christina M Lachner | Counselor | 125 N 6th Ave, Suite 201, West Bend, WI 53095-3394 | 2012-03-10 |
1720361140 | Lester Menke | Counselor | 625 Westridge Dr Apt 11, West Bend, WI 53095-3638 | 2011-09-21 |
1285885947 | Nancy Jean Parker | Counselor | 126a E Washington St, West Bend, WI 53095-2578 | 2008-09-30 |
1881714681 | Erika M Bublitz | Counselor | 215 N Main St Ste 204, West Bend, WI 53095-3347 | 2007-03-29 |
1821136037 | Lisa A Tieglman Koepp | Counselor | 1615 Barton Avenue, Northshore Clinic & Consultants Inc, West Bend, WI 53090 | 2007-02-01 |
1255484564 | Linda J Kirk | Counselor | 215 N Main St Ste 201, West Bend, WI 53095-3337 | 2007-01-19 |
1275148736 | Sherzing Moua | Counselor | 724 Elm St, West Bend, WI 53095-3205 | 2020-09-11 |
1710538871 | Paige Lorraine Flanagan | Counselor | 1622 Chestnut St, West Bend, WI 53095-3014 | 2019-09-20 |
Find all providers in WEST BEND |
Please comment or provide details below to improve the information on LYNN GILLIAN-NOWAK.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.