Individual
LISA ANN WITKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C, LPC
Contact information
Practice address
1121 BELLWEST BLVD, BELLEVILLE, WI 53508-9433
(608) 424-3384
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4213-125
WI
101YP2500X
Professional Counselor
4213-125
WI
363A00000X
Physician Assistant
7951-23
WI
363AM0700X
Medical Physician Assistant
Primary
7951
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14292
AODA CREDENTIAL
WI
01
—
41 - 226
WI DRL, LPC-TRAINING LIC.
WI
Enumeration date
09/24/2006
Last updated
12/18/2024
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