Individual
KEVIN P LUNOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, CSAC
Contact information
Practice address
200 HICKORY STREET, MAUSTON, WI 53948
(608) 847-2400
(608) 847-9599
Mailing address
200 HICKORY STREET, MAUSTON, WI 53948
(608) 847-2400
(608) 847-9599
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1594-132
WI
101YP2500X
Professional Counselor
1020
WI
101YP2500X
Professional Counselor
1020-125
WI
1041C0700X
Clinical Social Worker
3191
WI
1041C0700X
Clinical Social Worker
Primary
3191-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39273700
—
WI
Enumeration date
04/08/2008
Last updated
04/19/2021
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