Provider Demographics
NPI:1538825864
Name:PACHECO USCANGA, ROSA DEL CARMEN (LPC)
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:DEL CARMEN
Last Name:PACHECO USCANGA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5131 E CHERYL PKWY APT 315
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-7729
Mailing Address - Country:US
Mailing Address - Phone:414-241-4347
Mailing Address - Fax:
Practice Address - Street 1:5131 E CHERYL PKWY APT 315
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-7729
Practice Address - Country:US
Practice Address - Phone:414-241-4347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8326101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional