Provider Demographics
NPI:1144351438
Name:LANPHEAR, KERI MAE (MS, LPC, SAC-IT)
Entity type:Individual
Prefix:MS
First Name:KERI
Middle Name:MAE
Last Name:LANPHEAR
Suffix:
Gender:F
Credentials:MS, LPC, SAC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 RIVERBEND DR
Mailing Address - Street 2:APT. 6
Mailing Address - City:HARTFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53027-9473
Mailing Address - Country:US
Mailing Address - Phone:262-670-6324
Mailing Address - Fax:
Practice Address - Street 1:9330 W LINCOLN AVE
Practice Address - Street 2:SUITE 21
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-2300
Practice Address - Country:US
Practice Address - Phone:414-546-6880
Practice Address - Fax:414-546-6234
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14825101YA0400X
WI3871-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health