Ackerman, Thomas Dieden

Ackerman, Thomas Dieden is an individual health care provider with primary practice located at 2925 Mondovi Rd , Eau Claire WI 54701-6141. He recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as his primary health care specialty. Ackerman, Thomas Dieden can be contacted via phone (715) 832-0238.

Contact Information

Primary practice address
2925 Mondovi Rd Eau Claire WI 54701-6141
Phone: (715) 832-0238
Fax: (715) 832-0771
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 6547-123 Wisconsin

Profile Details

NPI number 1649342338
LBN Legal business name Ackerman, Thomas Dieden
Credentials MSW
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649342338 NPPES
Wisconsin Other 105505 SECURITY HEALTH PLAN #
Wisconsin Other 6547-123 SECURITY HEALTH PLAN #
Wisconsin MEDICAID 39759400 SECURITY HEALTH PLAN #

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