Provider Demographics
NPI:1124390273
Name:KAUPPI, MARTHA (MS LMFT)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:KAUPPI
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 ZWERG DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-5230
Mailing Address - Country:US
Mailing Address - Phone:608-698-4171
Mailing Address - Fax:
Practice Address - Street 1:111 S 1ST ST
Practice Address - Street 2:SUITE 120
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-5236
Practice Address - Country:US
Practice Address - Phone:608-244-4066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2014-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI962-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist