Borth, Harry R.

Borth, Harry R. is an individual health care provider with primary practice located at 3535 30Th Ave Suite 202, Kenosha WI 53144-1632. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Borth, Harry R. can be contacted via phone (262) 842-0500.

Contact Information

Primary practice address
3535 30Th Ave Suite 202 Kenosha WI 53144-1632
Phone: (262) 842-0500
Fax: (262) 842-0502
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 1059-123 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1024-132 Wisconsin

Profile Details

NPI number 1336162072
LBN Legal business name Borth, Harry R.
Credentials MSW, LCSW, CSAC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated May 26th, 2008 - about 16 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 1336162072 NPPES
Wisconsin MEDICAID 39319100

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