Provider Demographics
NPI:1588103824
Name:GEISER, KATHERINE (LPC, CSAC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:GEISER
Suffix:
Gender:F
Credentials:LPC, CSAC
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:GUSTAFSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4230 E TOWNE BLVD # 316
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-3704
Mailing Address - Country:US
Mailing Address - Phone:608-480-8013
Mailing Address - Fax:
Practice Address - Street 1:2800 E ENTERPRISE AVE
Practice Address - Street 2:STE 333
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913
Practice Address - Country:US
Practice Address - Phone:608-480-8013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-20
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7116101YA0400X
WI17757-130101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI3441-226Medicaid