Provider Demographics
NPI:1336794643
Name:SENGKHAMMEE, ELIZABETH MAY (LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MAY
Last Name:SENGKHAMMEE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 W POINT RD
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54304-1344
Mailing Address - Country:US
Mailing Address - Phone:920-490-3882
Mailing Address - Fax:920-490-3883
Practice Address - Street 1:2640 W POINT RD
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-1344
Practice Address - Country:US
Practice Address - Phone:920-490-3882
Practice Address - Fax:920-490-3883
Is Sole Proprietor?:No
Enumeration Date:2019-08-04
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10044-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical