Individual
AMY J KISTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5007 S HOWELL AVE STE 350, MILWAUKEE, WI 53207-6159
(262) 999-3495
Mailing address
4800 N SCOTTSDALE RD STE 2500, SCOTTSDALE, AZ 85251-7630
(262) 999-3495
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
3955-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3955-125
STATE LICENSURE
WI
05
—
43700200
—
WI
Enumeration date
11/29/2006
Last updated
08/13/2025
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