Provider Demographics
NPI:1063566651
Name:GIESE, CHRISTOPHER A (LPC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:A
Last Name:GIESE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 MONDOVI RD
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-6141
Mailing Address - Country:US
Mailing Address - Phone:715-832-0238
Mailing Address - Fax:715-832-0771
Practice Address - Street 1:501 S CHERRY AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-4263
Practice Address - Country:US
Practice Address - Phone:715-381-5437
Practice Address - Fax:715-381-5438
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3752125101YM0800X
WI3752-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43701000Medicare ID - Type Unspecified