DR. PAMELA A KACZMAREK (NPI# 1578786042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578786042 |
| Entity Type | Individual |
| Full Name | DR. PAMELA A KACZMAREK |
| Credential | PSYD |
| Practice Address |
3220 80th St Kenosha WI 53142-4948 |
| Practice Telephone | 2623586707 |
| Mailing Telephone | 2623586707 |
| Mailing Fax Number | 8663322720 |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-03-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
178003041 | IL | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
3007-57 | WI | Behavioral Health & Social Service Providers |
| Street Address |
3220 80TH ST |
| City | KENOSHA |
| State | WI |
| Zip Code | 53142-4948 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215196563 | Kenneth John Wendorf | Dentist | 3220 80th St, Kenosha, WI 53142-4948 | 2008-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588297816 | Caring Hearts Home Health Care | In Home Supportive Care | 6021-57th Ave, Suite C103, Kenosha, WI 53142 | 2020-02-14 |
| 1144785395 | Michael L Wrzesinski | Counselor | 4109 67th Street, Kenosha, WI 53142 | 2019-02-01 |
| 1720538499 | David Smith | Counselor | 10900 67th Street, Kenosha, WI 53142 | 2016-10-06 |
| 1326404641 | Smile Doctors Ltd | Dentist | 7003 39th Ave, Kenosha, WI 53142 | 2016-01-04 |
| 1225409485 | Antonia Marie Decker | Physician Assistant | 10400 75th St. Ste 204, Kenosha, WI 53142 | 2015-10-14 |
| 1780060582 | Joshua Haas | Pharmacist | 7701 Green Bay Road, Kenosha, IL 53142 | 2015-08-04 |
| 1811379225 | Dana Mary Stout | Registered Nurse | 7401 104th Avenue, Suite 110, Comprehensive Orthopaedics, S.c., Kenosha, WI 53142 | 2015-06-22 |
| 1669815569 | Joshua Knute Elson | Radiology | 6811 118th Ave, Kenosha, WI 53142 | 2013-04-10 |
| 1356610166 | Michael J Gallo | Pharmacist | 7535 North Greenbay Rd, Kenosha, WI 53142 | 2011-12-22 |
| 1720357999 | Orest Carnevale | Registered Nurse | 7316 155th Ct, Kenosha, WI 53142 | 2011-12-18 |
| Find all providers in zip 53142 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558619379 | Leah J Featherstone | Psychologist | 2108-63 Street, Kenosha, WI 53143-4454 | 2012-08-28 |
| 1336412360 | Kristin M Keeler, S.c | Psychologist | 4217 Green Bay Rd, Kenosha, WI 53144-4518 | 2012-02-22 |
| 1497957724 | Janice Alberdiena Vanniel | Psychologist | 7807 15th Ave, Kenosha, WI 53143-5913 | 2007-05-31 |
| 1821345372 | Dana Michelle Ballewske | Psychologist | 2108 63rd St, Kenosha, WI 53143-4454 | 2012-08-14 |
| 1124213954 | Michael Matthew Mihajlovic | Psychologist | 4536 22nd Ave, Kenosha, WI 53140-5917 | 2007-09-14 |
| 1487868584 | Kristin Marie Keeler | Psychologist | 5024 Green Bay Rd, Suite 120, Kenosha, WI 53144-1702 | 2007-05-09 |
| 1780769810 | Verna F. Christy | Psychologist | 5017 Green Bay Rd Ste 130, Kenosha, WI 53144-1782 | 2006-10-26 |
| 1467537423 | Debra Johansen | Psychologist | 6121 Green Bay Rd, Suite 230, Kenosha, WI 53142-2926 | 2006-10-26 |
| 1952482267 | Leesa Marie Wiedholz-abbott | Psychologist | 3734 7th Ave, Suite 12, Kenosha, WI 53140-5525 | 2006-10-17 |
| 1649291923 | Kalpana Rao | Psychologist | 6123 Green Bay Rd, Kenosha, WI 53142-2927 | 2006-07-21 |
| Find all providers in KENOSHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.