Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Tory Phonsavan Koetterhagen, LCSW

Individual provider Clinical Social Worker · NPI 1093281370

Mrs. Tory Phonsavan Koetterhagen, LCSW is a Clinical Social Worker in Waukesha, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2018
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

W236S4564 Whispering Hills Ct
Waukesha, WI 53189-9772
Phone: (414) 467-6994
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 8075-123 (WI)

Record details

NPI number1093281370
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedOctober 15, 2018
Last updated in NPPESOctober 15, 2018

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