Houston, Carisa Marie

Houston, Carisa Marie is an individual health care provider with primary practice located at 4800 S 10Th St , Milwaukee WI 53221-2412. 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. Houston, Carisa Marie can be contacted via phone (414) 744-5370.

Contact Information

Primary practice address
4800 S 10Th St Milwaukee WI 53221-2412
Phone: (414) 744-5370
Fax: (414) 744-9052
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 15528131 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 15446 Illinois
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 15606-132 Wisconsin

Profile Details

NPI number 1376729996
LBN Legal business name Houston, Carisa Marie
Credentials SAC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 14th, 2008
Last updated Aug 17th, 2011 - about 13 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 1376729996 NPPES
Wisconsin MEDICAID 1376729996

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