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Individual

LESLIE ANN KONEK-SCHLAX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
6121 GREEN BAY RD, KENOSHA, WI 53142-2926
(262) 652-7222
(262) 652-1734
Mailing address
4633 WASHINGTON RD, KENOSHA, WI 53144-4220
(262) 652-7222
(262) 652-1734

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2531-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
182658
VALUE OPTIONS
01
234314
MANAGED HEALTH NETWORK
05
39555200
WI
01
7093066
AETNA
01
80448
UNITED BEHAVIORAL HEALTH
01
900693
CENPATICO BEHAVIORAL HLTH
01
W009675
TRICARE (CHAMPUS)
Enumeration date
12/11/2006
Last updated
10/05/2016
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