Grady, Paul
Grady, Paul is an individual health care provider with primary practice located at 121 W Main St , Port Washington WI 53074-1813. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Grady, Paul can be contacted via phone (262) 284-8200.Contact Information
Primary practice address
121 W Main St
Port Washington WI 53074-1813
Phone: (262) 284-8200
Fax: (282) 284-8104
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 807123 | Wisconsin |
Profile Details
| NPI number | 1902897010 |
|---|---|
| LBN Legal business name | Grady, Paul |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 31st, 2005 |
| Last updated | Oct 27th, 2014 - about 10 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 | 1902897010 | NPPES |
| Wisconsin | MEDICAID | 39240800 |
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