Individual
MEGAN KETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081-3129
(920) 457-4461
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
129206-121
WI
1041C0700X
Clinical Social Worker
Primary
11721-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100225398
—
WI
Enumeration date
01/16/2023
Last updated
02/17/2025
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