Provider Demographics
NPI:1902653405
Name:STINSON, KATIE MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:MARIE
Last Name:STINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:MARIE
Other - Last Name:MESSING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 234
Mailing Address - Street 2:
Mailing Address - City:WINNEBAGO
Mailing Address - State:WI
Mailing Address - Zip Code:54985-0234
Mailing Address - Country:US
Mailing Address - Phone:920-312-7719
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 234
Practice Address - Street 2:
Practice Address - City:WINNEBAGO
Practice Address - State:WI
Practice Address - Zip Code:54985-0234
Practice Address - Country:US
Practice Address - Phone:920-312-7719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8907-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical