Anderson, Dennis J

Anderson, Dennis J is an individual health care provider with primary practice located at 1317 W Grand Ave , Port Washington WI 53074-2075. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Anderson, Dennis J can be contacted via phone (262) 284-5789.

Contact Information

Primary practice address
1317 W Grand Ave Port Washington WI 53074-2075
Phone: (262) 284-5789
Fax: (262) 284-5907
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 2249 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 3072-123 Wisconsin

Profile Details

NPI number 1265479257
LBN Legal business name Anderson, Dennis J
Credentials LCSW CADCIII
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Oct 18th, 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 1265479257 NPPES
Wisconsin MEDICAID 39730700

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