Individual
TINA STASZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
5235 N IRONWOOD RD, GLENDALE, WI 53217-4906
(414) 902-1519
Mailing address
5235 N IRONWOOD RD, GLENDALE, WI 53217-4906
(414) 902-1519
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
17478-130
WI
101YM0800X
Mental Health Counselor
Primary
3348-226
WI
101YP2500X
Professional Counselor
Primary
7063-125
WI
Other
Enumeration date
12/08/2016
Last updated
04/28/2026
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