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Individual

KRYSTLE ELIZABETH HAVILAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC, CSAC, ICS

Contact information

Practice address
159 S FAIR OAKS AVE, MADISON, WI 53704-5820
(608) 620-5209
Mailing address
2413 MIDDLETON BEACH RD, MIDDLETON, WI 53562-2910
(715) 781-1653

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16489-130
WI
101YM0800X
Mental Health Counselor
Primary
1238-266
WI
101YM0800X
Mental Health Counselor
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Enumeration date
02/09/2012
Last updated
02/21/2024
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