Provider Demographics
NPI:1013595792
Name:ISENBERGER, PATRICK (CSAC)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:ISENBERGER
Suffix:
Gender:
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 S TOWNLINE RD
Mailing Address - Street 2:
Mailing Address - City:WAUTOMA
Mailing Address - State:WI
Mailing Address - Zip Code:54982-6900
Mailing Address - Country:US
Mailing Address - Phone:920-787-6550
Mailing Address - Fax:920-787-0421
Practice Address - Street 1:380 S TOWNLINE RD
Practice Address - Street 2:
Practice Address - City:WAUTOMA
Practice Address - State:WI
Practice Address - Zip Code:54982-6900
Practice Address - Country:US
Practice Address - Phone:920-787-6550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2056101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)