Provider Demographics
NPI:1851869895
Name:MCNIEL, KATHRYN MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARIE
Last Name:MCNIEL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N GREEN BAY RD
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-2285
Mailing Address - Country:US
Mailing Address - Phone:425-477-9044
Mailing Address - Fax:
Practice Address - Street 1:250 N GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-2285
Practice Address - Country:US
Practice Address - Phone:425-477-9044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-07
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program