Cardinal, Amanda R

Cardinal, Amanda R is an sole proprietor health care provider with primary practice located at 123 N Oakland Ave , Green Bay WI 54303-2831. She recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Cardinal, Amanda R can be contacted via phone (920) 770-4088.

Contact Information

Primary practice address
123 N Oakland Ave Green Bay WI 54303-2831
Phone: (920) 770-4088
Fax: (651) 705-0026
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X 6319-125 Wisconsin
Behavioral Health & Social Service Providers / Professional 101YP2500X 6319 Wisconsin

Profile Details

NPI number 1265969950
LBN Legal business name Cardinal, Amanda R
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 12th, 2017
Last updated Apr 23rd, 2024 - about last year

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 1265969950 NPPES
Wisconsin MEDICAID 100068903

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