Ishatova, Ciel

Ishatova, Ciel is an sole proprietor health care provider with primary practice located at 1619 Monroe St , Madison WI 53711-2063. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Ishatova, Ciel can be contacted via phone (608) 255-9330.

Contact Information

Primary practice address
1619 Monroe St Madison WI 53711-2063
Fax: (608) 255-7810
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 2248-123 Wisconsin
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 261-124 Wisconsin

Profile Details

NPI number 1639110398
LBN Legal business name Ishatova, Ciel
Credentials LCSW, LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 10th, 2006
Last updated Jul 15th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639110398 NPPES
Wisconsin MEDICAID 39255100

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