Cisco, Washington
Cisco, Washington is an individual health care provider with primary practice located at 2870 E Jefferson St , Centralia IL 62801-8530. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Cisco, Washington can be contacted via phone (618) 249-6863.Contact Information
Primary practice address
2870 E Jefferson St
Centralia IL 62801-8530
Phone: (618) 249-6863
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 149.005632 | Illinois |
Profile Details
| NPI number | 1457698912 |
|---|---|
| LBN Legal business name | Cisco, Washington |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 3rd, 2013 |
| Last updated | Jan 3rd, 2013 - about 11 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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