Provider Demographics
NPI:1043833270
Name:HORNAK, LINDA FLAHIVE (LPC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:FLAHIVE
Last Name:HORNAK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W4063 HWY NN
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:WI
Mailing Address - Zip Code:53121-4338
Mailing Address - Country:US
Mailing Address - Phone:262-741-1440
Mailing Address - Fax:
Practice Address - Street 1:W4063 HWY NN
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:WI
Practice Address - Zip Code:53121-4338
Practice Address - Country:US
Practice Address - Phone:262-741-1440
Practice Address - Fax:262-743-2221
Is Sole Proprietor?:No
Enumeration Date:2020-05-21
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8426-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1043833270Medicaid