Provider Demographics
NPI:1346077294
Name:KREIE-YANG, ALEXANDRIA DEBORAH LEIGH (LCSW)
Entity type:Individual
Prefix:MS
First Name:ALEXANDRIA
Middle Name:DEBORAH LEIGH
Last Name:KREIE-YANG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ALEXANDRIA
Other - Middle Name:DEBORAH LEIGH
Other - Last Name:KREIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 MEMORY AVE
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-2228
Mailing Address - Country:US
Mailing Address - Phone:715-432-8942
Mailing Address - Fax:
Practice Address - Street 1:601 MEMORY AVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-2228
Practice Address - Country:US
Practice Address - Phone:715-432-8942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11825-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical