Baeten, Tina Marie
Baeten, Tina Marie is an individual health care provider with primary practice located at 2920 S Webster Ave Ste B , Green Bay WI 54301-1594. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Baeten, Tina Marie can be contacted via phone (920) 632-4471.Contact Information
Primary practice address
2920 S Webster Ave Ste B
Green Bay WI 54301-1594
Phone: (920) 632-4471
Fax: (920) 632-4315
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 13791 | Wisconsin |
Profile Details
| NPI number | 1386793248 |
|---|---|
| LBN Legal business name | Baeten, Tina Marie |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 9th, 2007 |
| Last updated | Dec 6th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386793248 | NPPES |
| Wisconsin | MEDICAID | 39382000 |
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