Individual
MR. KURT L. MAHNKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1477 KENWOOD CTR, MENASHA, WI 54952-1160
(920) 729-6780
Mailing address
2800 E ENTERPRISE AVE, APPLETON, WI 54913-7889
(920) 729-6780
(920) 560-4501
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
252-125
WI
1041C0700X
Clinical Social Worker
Primary
892-123
WI
106H00000X
Marriage & Family Therapist
122-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43701400
—
WI
Enumeration date
01/03/2007
Last updated
01/25/2010
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