MR. KEVIN S GUNDERSON M.S.E. NPI 1336454412

NPI Information

NPI: 1336454412
Provider Name: MR. KEVIN S GUNDERSON, M.S.E.
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
2745 BAYLITE DR
GREEN BAY, WI
ZIP 54313
Phone: (920) 362-2152
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MR. Kevin S Gunderson, M.S.E. is a professional counselor in Green Bay, WI. MR. Kevin S Gunderson, M.S.E. NPI is 1336454412. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2745 BAYLITE DR
GREEN BAY, WI
ZIP 54313-173
Phone: (920) 362-2152

The enumeration date for this NPI number is 8/12/2010 and was last updated on 9/14/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	887-226	WISCONSIN	No
2	101YP2500X	Counselor	Professional	5011-125	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100029719	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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