Provider Demographics
NPI:1861562373
Name:HOOVER, NANCY K (LPC)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:K
Last Name:HOOVER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:K
Other - Last Name:KLOSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2125 FAIRFAX STREET
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-4683
Mailing Address - Country:US
Mailing Address - Phone:715-831-8305
Mailing Address - Fax:715-831-0440
Practice Address - Street 1:4330 GOLF TER
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-4683
Practice Address - Country:US
Practice Address - Phone:715-831-8305
Practice Address - Fax:715-831-0440
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3522-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40985100Medicaid