Individual provider · Type 1 NPI

Tory Phonsavan Koetterhagen, LCSW

Clinical Social Worker · Waukesha, WI

NPI number 1093281370 Active

Practice location

W236S4564 Whispering Hills Ct
Waukesha, WI 53189-9772

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X8075-123 (WI)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1093281370

Tory Phonsavan Koetterhagen, LCSW's National Provider Identifier is 1093281370, issued on Oct 15, 2018. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Waukesha, WI. The record was last updated on Oct 15, 2018.