Provider Demographics
NPI:1144634189
Name:STRIEBEL, JOELLA
Entity type:Individual
Prefix:
First Name:JOELLA
Middle Name:
Last Name:STRIEBEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 5TH AVE S STE 523
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-4018
Mailing Address - Country:US
Mailing Address - Phone:608-518-6068
Mailing Address - Fax:608-782-4426
Practice Address - Street 1:115 5TH AVE S STE 523
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-4018
Practice Address - Country:US
Practice Address - Phone:608-518-6068
Practice Address - Fax:608-782-4426
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-18
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15896131101YA0400X
WI16273101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)