Individual
MS. KELLY LYN MISFELDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW CSAC
Contact information
Practice address
2661 COUNTY HIGHWAY I, CHIPPEWA FALLS, WI 54729-5407
(715) 723-5585
Mailing address
2661 COUNTY HIGHWAY I, CHIPPEWA FALLS, WI 54729-5407
(715) 723-5585
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15451-132
WI
104100000X
Social Worker
8511-120
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15451-132
STATE
WI
01
—
8511-120
STATE
WI
Enumeration date
06/07/2012
Last updated
06/07/2012
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