Provider Demographics
NPI:1649255381
Name:OSWALD, LYNNE T (LCSW, LPC, CADC3)
Entity type:Individual
Prefix:
First Name:LYNNE
Middle Name:T
Last Name:OSWALD
Suffix:
Gender:F
Credentials:LCSW, LPC, CADC3
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2919 DEER RD
Mailing Address - Street 2:
Mailing Address - City:ROSHOLT
Mailing Address - State:WI
Mailing Address - Zip Code:54473-9511
Mailing Address - Country:US
Mailing Address - Phone:715-592-3551
Mailing Address - Fax:
Practice Address - Street 1:1004 1ST ST
Practice Address - Street 2:SUITE 4
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-2627
Practice Address - Country:US
Practice Address - Phone:715-342-0290
Practice Address - Fax:715-342-0291
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-14
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI482125101YM0800X
WI2278-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1761OtherCADC3
WI39643200Medicaid