Individual
KIMBERLY WILLIAMS-NYBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, SAC
Contact information
Practice address
320 S WALNUT ST, APPLETON, WI 54911-5918
(920) 832-5241
Mailing address
320 S WALNUT ST, APPLETON, WI 54911-5918
(920) 832-5241
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16279-131
WI
101YP2500X
Professional Counselor
3546-226
WI
101YP2500X
Professional Counselor
Primary
7404-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100077178
—
WI
Enumeration date
03/20/2017
Last updated
12/12/2023
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