Individual
GREGORY JOHN KRESSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, SAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12116-131
WI
1041C0700X
Clinical Social Worker
Primary
3777-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12116-131
SAC - LICENSE
WI
01
—
3777-123
LCSW - LICENSE
WI
Enumeration date
09/06/2006
Last updated
04/15/2013
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