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Individual

KELSEY ANN MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW, CSAC, ICS

Contact information

Practice address
571 BRAUND ST, ONALASKA, WI 54650-8556
(608) 785-7000
(608) 785-7477
Mailing address
1419 ISLAND ST, LA CROSSE, WI 54603-2848
(920) 420-4919

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1041C0700X
Clinical Social Worker
Primary
9224
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100076316
WI
Enumeration date
03/13/2018
Last updated
02/17/2021
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