Decarlo-Kienitz, Lori Anne
Decarlo-Kienitz, Lori Anne is an individual health care provider with primary practice located at 502 Main St W Ste 305 , Ashland WI 54806-1512. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Decarlo-Kienitz, Lori Anne can be contacted via phone (715) 682-5207.Contact Information
Primary practice address
502 Main St W Ste 305
Ashland WI 54806-1512
Phone: (715) 682-5207
Fax: (715) 682-5209
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 14014-132 | Wisconsin |
Profile Details
| NPI number | 1023138112 |
|---|---|
| LBN Legal business name | Decarlo-Kienitz, Lori Anne |
| Credentials | CSAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 30th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 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 | 1023138112 | NPPES |
| Wisconsin | MEDICAID | 39166400 |
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