Cissna, Charles William

Cissna, Charles William is an individual health care provider with primary practice located at 822 Woodway St , Bowling Green KY 42101-2771. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Cissna, Charles William can be contacted via phone (270) 901-5000.

Contact Information

Primary practice address
822 Woodway St Bowling Green KY 42101-2771
Phone: (270) 901-5000
Fax: (270) 842-5268
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 0197 Kentucky

Profile Details

NPI number 1639249311
LBN Legal business name Cissna, Charles William
Credentials LPCA
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2006
Last updated Jul 9th, 2007 - about 18 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 1639249311 NPPES
Kentucky MEDICAID 60604011

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