Chubbuck, Judson
Chubbuck, Judson is an individual health care provider with primary practice located at 16535 W Bluemound Rd Suite 200, Brookfield WI 53005-5936. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Chubbuck, Judson can be contacted via phone (262) 789-1191.Contact Information
Primary practice address
16535 W Bluemound Rd Suite 200
Brookfield WI 53005-5936
Phone: (262) 789-1191
Fax: (262) 821-6180
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 3233125 | Wisconsin |
Profile Details
| NPI number | 1245393388 |
|---|---|
| LBN Legal business name | Chubbuck, Judson |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 19th, 2006 |
| Last updated | Feb 5th, 2009 - 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 | 1245393388 | NPPES |
| Wisconsin | MEDICAID | 40963300 |
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