Provider Demographics
NPI:1104276195
Name:SZYPEREK, ANNA J (LPC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:J
Last Name:SZYPEREK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:GIRDAUSKAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC-IT
Mailing Address - Street 1:444 N WESTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-5715
Mailing Address - Country:US
Mailing Address - Phone:920-735-7480
Mailing Address - Fax:920-364-2415
Practice Address - Street 1:444 N. WESTHILL BLVD
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-5715
Practice Address - Country:US
Practice Address - Phone:920-750-7000
Practice Address - Fax:920-364-2451
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3093-226101YM0800X
WI101YM0800X
WI6904101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100057408Medicaid