Provider Demographics
NPI:1871552216
Name:GETZEL, KRISTA (MSW,LCSW)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:GETZEL
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N91W17271 APPLETON AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-2045
Mailing Address - Country:US
Mailing Address - Phone:262-502-3300
Mailing Address - Fax:
Practice Address - Street 1:N91W17271 APPLETON AVE STE 1
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-2045
Practice Address - Country:US
Practice Address - Phone:262-502-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2638104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39692900Medicaid
WIR88931Medicare UPIN
WI39692900Medicaid
WI84145Medicare PIN
WI68375Medicare PIN