Provider Demographics
NPI:1386745461
Name:KASPERSON, JANICE K (LCSW)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:K
Last Name:KASPERSON
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 1:101 THOMPSON RD
Mailing Address - Street 2:
Mailing Address - City:WASHBURN
Mailing Address - State:WI
Mailing Address - Zip Code:54891-4525
Mailing Address - Country:US
Mailing Address - Phone:715-373-2233
Mailing Address - Fax:715-373-5530
Practice Address - Street 1:101 THOMPSON RD
Practice Address - Street 2:
Practice Address - City:WASHBURN
Practice Address - State:WI
Practice Address - Zip Code:54891-4525
Practice Address - Country:US
Practice Address - Phone:715-373-2233
Practice Address - Fax:715-373-5530
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6156-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39715400Medicaid