Provider Demographics
NPI:1275028508
Name:SZAMBELAN, PATRICIA JOAN (MS,LPC,CSAC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JOAN
Last Name:SZAMBELAN
Suffix:
Gender:
Credentials:MS,LPC,CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4140 GANDY DANCER RD
Mailing Address - Street 2:
Mailing Address - City:DEFOREST
Mailing Address - State:WI
Mailing Address - Zip Code:53532-9118
Mailing Address - Country:US
Mailing Address - Phone:608-931-2805
Mailing Address - Fax:
Practice Address - Street 1:787 LOIS DR
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-1177
Practice Address - Country:US
Practice Address - Phone:608-931-2805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-28
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16446-132101YA0400X
WI7797-125101YM0800X
WI7797101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health