Provider Demographics
NPI:1730823279
Name:STICE, MOLLY CATHLEEN HOEHN (LMFT)
Entity type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:CATHLEEN HOEHN
Last Name:STICE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MISS
Other - First Name:MOLLY
Other - Middle Name:CATHLEEN
Other - Last Name:HOEHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:320 S. WALNUT ST.
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-5918
Mailing Address - Country:US
Mailing Address - Phone:920-832-5270
Mailing Address - Fax:920-832-4767
Practice Address - Street 1:320 S. WALNUT ST.
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-5918
Practice Address - Country:US
Practice Address - Phone:920-832-5270
Practice Address - Fax:920-832-4767
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI815-228106H00000X
WI2239-14106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100199137Medicaid