Individual
ISAAC THEODORE KABACINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
119 N MCCARTHY RD STE P, APPLETON, WI 54913-9112
(920) 903-1060
(920) 903-1164
Mailing address
119 N MCCARTHY RD STE P, APPLETON, WI 54913-9112
(920) 903-1060
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10053-123
WI
1041C0700X
Clinical Social Worker
131888-121
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100138546
—
WI
Enumeration date
07/06/2020
Last updated
12/12/2022
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