Kendziorski, Betsy A

Kendziorski, Betsy A is an individual health care provider with primary practice located at 1317 W Grand Ave , Port Washington WI 53074-2075. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Kendziorski, Betsy A can be contacted via phone (262) 284-5789.

Contact Information

Primary practice address
1317 W Grand Ave Port Washington WI 53074-2075
Fax: (262) 284-5907
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 2806-123 Wisconsin

Profile Details

NPI number 1861446320
LBN Legal business name Kendziorski, Betsy A
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated Oct 18th, 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 1861446320 NPPES
Wisconsin MEDICAID 39256100

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