Individual
MICHELLE GAUGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSE, LPC, SAC
Contact information
Practice address
300 CROOKS ST, GREEN BAY, WI 54301-4527
(920) 436-6800
(920) 432-5966
Mailing address
300 CROOKS ST, GREEN BAY, WI 54301-4527
(920) 436-6800
(920) 432-5966
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15830-132
WI
101YM0800X
Mental Health Counselor
5114-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154606317
—
WI
01
—
15830-132
WISCONSIN DEPT OF SAFETY AND PROFESSIONAL SERVICES
WI
01
—
5114-125
WISCONSIN DEPT OF SAFETY AND PROFESSIONAL SERVICES
WI
Enumeration date
10/19/2011
Last updated
02/11/2014
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