Provider Demographics
NPI:1689947384
Name:MARX, THOMAS C (LPC, CSAC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:C
Last Name:MARX
Suffix:
Gender:
Credentials:LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:S22W22660 BROADWAY STE 5
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-8100
Mailing Address - Country:US
Mailing Address - Phone:262-500-4267
Mailing Address - Fax:262-753-6914
Practice Address - Street 1:S22W22660 BROADWAY STE 5
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-8100
Practice Address - Country:US
Practice Address - Phone:262-500-4267
Practice Address - Fax:262-753-6914
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-12
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17148-133101YA0400X
WI5330-125101YP2500X
WI15921-132101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)