Provider Demographics
NPI:1043024581
Name:KLEMP, TRICIA M (LPC-IT, SAC-IT)
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:M
Last Name:KLEMP
Suffix:
Gender:F
Credentials:LPC-IT, SAC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 MARSHALL ST STE A
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-6799
Mailing Address - Country:US
Mailing Address - Phone:715-848-4600
Mailing Address - Fax:
Practice Address - Street 1:2400 MARSHALL ST STE A
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403-6799
Practice Address - Country:US
Practice Address - Phone:715-848-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20464101YA0400X
WI8326101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)