Individual
MS. KATHY L MESA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4025 N 92ND ST, WAUWATOSA, WI 53222-1613
(414) 435-1115
(414) 435-0543
Mailing address
3222 S PENNSYLVANIA AVE, MILWAUKEE, WI 53207-3132
(414) 374-2831
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1804-226
WI
101YP2500X
Professional Counselor
1804-226
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100048711
—
WI
Enumeration date
09/01/2013
Last updated
03/06/2023
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