Sara Gaska, LPC, CSAC, ICS

Individual provider Active NPI Mental Health Counselor · Juneau, WI

NPI 1790984367 · NPPES record last updated Dec 15, 2011

Key facts

NPI
1790984367
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
3503-125 (WI)
Practice address
199 Home Rd
Juneau, WI 53039-1401
Phone
(920) 386-3500
Fax
(920) 386-3812
NPI assigned
Jul 13, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
15630-132WIMDAddiction (Substance Use Disorder) Counselor
3503-125WIMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3503-125 WI Yes
Addiction (Substance Use Disorder) Counselor 101YA0400X 15630-132 WI

Addresses

Primary practice location

199 Home Rd
Juneau, WI 53039-1401

Mailing address

199 Home Rd
Juneau, WI 53039-1401
Phone (920) 386-3500

Other identifiers

IdentifierTypeStateIssuer
40989200OtherWIT-19

Other providers in Juneau, WI

All providers in Juneau, WI · Mental Health Counselor in Wisconsin

Sources for this page

Verify at the official NPI Registry.