Stephen Arthur Declark in Racine - Clinical
Stephen Arthur Declark - NPI 1609051085
Stephen Arthur Declark is a Clinical in Racine, Wisconsin. Stephen Arthur Declark practices all healthcare services and medical treatments related to Clinical. The NPI Number for Stephen Arthur Declark is 1609051085. The last update date is 2008-01-04.
Stephen Arthur Declark's current location address is 700 Villa St, Racine, Wisconsin. You can contact this provider via phone number 2629025602 and fax number 2626193263. The mailing address for Stephen Arthur Declark is 700 Villa St, Racine, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stephen Arthur Declark |
|---|---|
| Address | 700 Villa St, Racine, Wisconsin |
| Phone Number | 2629025602 |
| Fax Number | 2626193263 |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1609051085 |
|---|---|
| Provider Enumeration Date | 2008-01-04 |
| Last Updated Date | 2008-01-04 |
Provider Mailing Address Detail
| Address | 700 Villa St |
|---|---|
| City | Racine |
| State | Wisconsin (WI) |
| Post Code | 534031144 |
| Phone Number | 2629025602 |
| Fax Number | 2626193263 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 6701-123 |
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Definition: 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, certif |
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What is the unique identification code assigned to Stephen Arthur Declark by the Centers for Medicare & Medicaid Services?
The Stephen Arthur Declark has been issued the NPI (National Provider Identifier) 1609051085. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Stephen Arthur Declark?
The Stephen Arthur Declark is physically situated at 700 Villa St, in the city of Racine, state of WI, with the postal code 534031144.
What is Stephen Arthur Declark's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Stephen Arthur Declark is Clinical, and the taxonomy code that classifies this field of practice is 1041C0700X.
On what date did Stephen Arthur Declark receive its 1609051085 assignment from the Centers for Medicare & Medicaid Services?
The Stephen Arthur Declark was assigned its 1609051085 on 2008-01-04, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Stephen Arthur Declark most recently updated?
The details pertaining to the Stephen Arthur Declark, including its address, specialty, and other relevant information, were last refreshed on 2008-01-04.
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