Provider Demographics
NPI:1194449652
Name:PORTSCHY, EMILY (SACIT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:PORTSCHY
Suffix:
Gender:F
Credentials:SACIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 347
Mailing Address - Street 2:
Mailing Address - City:KIEL
Mailing Address - State:WI
Mailing Address - Zip Code:53042-0347
Mailing Address - Country:US
Mailing Address - Phone:920-894-1374
Mailing Address - Fax:920-894-1373
Practice Address - Street 1:1102 W 1ST ST
Practice Address - Street 2:
Practice Address - City:WALDO
Practice Address - State:WI
Practice Address - Zip Code:53093-1309
Practice Address - Country:US
Practice Address - Phone:920-894-1374
Practice Address - Fax:920-894-1373
Is Sole Proprietor?:No
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19408101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)