Individual
MR. LEE KONCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12275
WI
1041C0700X
Clinical Social Worker
Primary
632123
WI
1041S0200X
School Social Worker
—
WI
Other
Enumeration date
08/05/2006
Last updated
02/13/2008
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