Bardin, Sally
Bardin, Sally is an individual health care provider with primary practice located at 101 Broad St Ste 201 , Lake Geneva WI 53147-2061. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Bardin, Sally can be contacted via phone (262) 248-7942.Contact Information
Primary practice address
101 Broad St Ste 201
Lake Geneva WI 53147-2061
Phone: (262) 248-7942
Fax: (262) 248-1202
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 3762-125 | Wisconsin |
Profile Details
| NPI number | 1679606529 |
|---|---|
| LBN Legal business name | Bardin, Sally |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 13th, 2007 |
| Last updated | Jul 8th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679606529 | NPPES |
| Wisconsin | MEDICAID | 43715500 |
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