Provider Demographics
NPI:1861784704
Name:STANGL, CLAIRE T (CSAC-IT, LPC-IT)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:T
Last Name:STANGL
Suffix:
Gender:F
Credentials:CSAC-IT, LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17100 W NORTH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-4450
Mailing Address - Country:US
Mailing Address - Phone:262-786-9184
Mailing Address - Fax:262-786-1906
Practice Address - Street 1:17100 W NORTH AVE STE 100
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-4450
Practice Address - Country:US
Practice Address - Phone:262-786-9184
Practice Address - Fax:262-786-1906
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15763-132101YA0400X
WI937-226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)