Provider Demographics
NPI:1124057294
Name:LAFRENZ, DUANNE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:DUANNE
Middle Name:
Last Name:LAFRENZ
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BROAD ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAKE GENEVA
Mailing Address - State:WI
Mailing Address - Zip Code:53147-2000
Mailing Address - Country:US
Mailing Address - Phone:262-248-7942
Mailing Address - Fax:
Practice Address - Street 1:101 BROAD ST
Practice Address - Street 2:SUITE 201
Practice Address - City:LAKE GENEVA
Practice Address - State:WI
Practice Address - Zip Code:53147-2000
Practice Address - Country:US
Practice Address - Phone:262-248-7942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39509900Medicaid