Provider Demographics
NPI:1194421610
Name:HAUSMAN, SHELBY (LPC)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:HAUSMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14755 W CAPITOL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-2318
Mailing Address - Country:US
Mailing Address - Phone:414-292-4242
Mailing Address - Fax:414-292-4182
Practice Address - Street 1:14755 W CAPITOL DR STE 100
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-2318
Practice Address - Country:US
Practice Address - Phone:414-292-4242
Practice Address - Fax:414-292-4182
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10994-125101YP2500X
WI101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional