Christianson, Gary L
Christianson, Gary L is an individual health care provider with primary practice located at 3267 S 16Th St Ohio Building - Room 209, Milwaukee WI 53215-4500. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Christianson, Gary L can be contacted via phone (414) 389-3111.Contact Information
Primary practice address
3267 S 16Th St Ohio Building - Room 209
Milwaukee WI 53215-4500
Phone: (414) 389-3111
Fax: (414) 389-3110
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1762-123 | Wisconsin |
Profile Details
| NPI number | 1164464905 |
|---|---|
| LBN Legal business name | Christianson, Gary L |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 12th, 2006 |
| Last updated | Apr 18th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164464905 | NPPES |
| Wisconsin | MEDICAID | 39621700 |
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