Dynamic Potential

LBN: Dynamic Potential
Dynamic Potential is an health care organization with primary practice located at 316 5Th St Ste 2 , Racine WI 53403-4606. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Family. Behavioral Health & Social Service Providers / Counseling is the primary health care specialty. Dynamic Potential can be contacted via phone (262) 308-8085, or through Raszkiewicz, Stephanie R via phone (262) 308-8085.

Contact Information

Primary practice address
316 5Th St Ste 2 Racine WI 53403-4606
Phone: (262) 308-8085
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Raszkiewicz, Stephanie R PHD
Phone: (262) 308-8085

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X
Behavioral Health & Social Service Providers / Counseling 103TC1900X
Behavioral Health & Social Service Providers / Family 103TF0000X

Profile Details

NPI number 1023656162
LBN Legal business name Dynamic Potential
DBA Doing business as
Authorized official Raszkiewicz, Stephanie R PHD
Entity Organization
Organization subpart 1 No
Enumeration date Dec 19th, 2019
Last updated Feb 24th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023656162 NPPES
Wisconsin MEDICAID 40968000

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