Northeast Wisconsin Behavioral Health Sc in Green Bay - Professional
Northeast Wisconsin Behavioral Health Sc - NPI 1275733602
Northeast Wisconsin Behavioral Health Sc is a Professional in Green Bay, Wisconsin. Northeast Wisconsin Behavioral Health Sc practices all healthcare services and medical treatments related to Professional. The NPI Number for Northeast Wisconsin Behavioral Health Sc is 1275733602. The last update date is 2023-10-16.
Northeast Wisconsin Behavioral Health Sc's current location address is 529 South Jefferson Street, Green Bay, Wisconsin. You can contact this provider via phone number 9208842175 and fax number 9208846735. The mailing address for Northeast Wisconsin Behavioral Health Sc is 529 South Jefferson Street, Green Bay, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Northeast Wisconsin Behavioral Health Sc |
|---|---|
| Address | 529 South Jefferson Street, Green Bay, Wisconsin |
| Phone Number | 9208842175 |
| Fax Number | 9208846735 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER, CEO |
|---|---|
| Authorized Official Name | Kosnar-Tittl Marie Suzette |
| Credentials | LICSW |
| Telephone Number | 9208842175 |
NPI Number Detail
| NPI Number | 1275733602 |
|---|---|
| Provider Enumeration Date | 2007-07-24 |
| Last Updated Date | 2023-10-16 |
Provider Mailing Address Detail
| Address | 529 South Jefferson Street |
|---|---|
| City | Green Bay |
| State | Wisconsin (WI) |
| Post Code | 543014125 |
| Phone Number | 9208842175 |
| Fax Number | 9208846735 |
Provider's Primary Taxonomy Detail
| Speciality | Professional |
|---|---|
| Taxonomy | 101Yp2500X |
| Licence No | 2376 125 |
|
Definition: A general counselor who helps people with personal, social, educational, and career issues. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 39722900 | WI | PROVIDER MEDICAID # | |
| 44900 | WI | CLINICMEDICARE# GREENBAY | |
| 1275733602 | WI | CLINIC NPI# | |
| 44905 | WI | CLINICMEDICARE#OSHKOSH | |
| 1285736249 | PROVIDER NPI | ||
| 144900 | WI | PROVIDERMEDICARE#GREENBAY | |
| 144905 | WI | PROVIDERMEDICARE#OSHKOSH | |
| 4225100 | WI | CLINIC MEDICAID # |
Post Comment/ Review Below
What is the unique provider identifier assigned to Northeast Wisconsin Behavioral Health Sc?
The Northeast Wisconsin Behavioral Health Sc has been issued the NPI (National Provider Identifier) 1275733602 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical location address where Northeast Wisconsin Behavioral Health Sc's facilities are situated?
The facilities of Northeast Wisconsin Behavioral Health Sc are physically located at the following address: 529 South Jefferson Street, Green Bay, WI, 543014125.
What is Northeast Wisconsin Behavioral Health Sc's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Northeast Wisconsin Behavioral Health Sc is Professional, and the taxonomy code that classifies this field of practice is 101Yp2500X.
On what date did the Northeast Wisconsin Behavioral Health Sc receive its 1275733602 assignment from the Centers for Medicare & Medicaid Services?
The Northeast Wisconsin Behavioral Health Sc was assigned its 1275733602 by the Centers for Medicare & Medicaid Services on 2007-07-24.
When was the information related to Northeast Wisconsin Behavioral Health Sc most recently updated or refreshed?
The details pertaining to the Northeast Wisconsin Behavioral Health Sc, including its address, specialty, and other relevant information, were last updated or refreshed on 2023-10-16.
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