Heller, Mary Kae
Heller, Mary Kae is an individual health care provider with primary practice located at 920 60Th St , Kenosha WI 53140-4041. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Heller, Mary Kae can be contacted via phone (262) 654-5333.Contact Information
Primary practice address
920 60Th St
Kenosha WI 53140-4041
Phone: (262) 654-5333
Fax: (262) 654-7818
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2238-123 | Wisconsin |
Profile Details
| NPI number | 1669511523 |
|---|---|
| LBN Legal business name | Heller, Mary Kae |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 6th, 2007 |
| Last updated | Jul 8th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669511523 | NPPES |
| Other | 234312 | MANAGED HEALTH NETWORK | |
| MEDICAID | 39603000 | MANAGED HEALTH NETWORK | |
| Other | 82202 | MANAGED HEALTH NETWORK |
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