Individual
EDWARD A DEHNERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1315 W MAIN ST, WATERTOWN, WI 53094-3564
(920) 261-4100
(920) 261-8801
Mailing address
1315 W MAIN ST, WATERTOWN, WI 53094-3564
(920) 261-4100
(920) 261-8801
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
7575-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15439-132
CLINICAL SUBSTANCE ABUSE COUNSELOR
WI
01
—
7575-123
LICENSED CLINICAL SOCIAL WORKER
WI
Enumeration date
08/17/2007
Last updated
10/18/2010
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