Koski, Wade Thomas
Koski, Wade Thomas is an individual health care provider with primary practice located at 4402 S 68Th St Suite 100, Greenfield WI 53220-3479. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Koski, Wade Thomas can be contacted via phone (414) 321-4411.Contact Information
Primary practice address
4402 S 68Th St Suite 100
Greenfield WI 53220-3479
Phone: (414) 321-4411
Fax: (414) 321-0552
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 7176-123 | Wisconsin |
Profile Details
| NPI number | 1235201914 |
|---|---|
| LBN Legal business name | Koski, Wade Thomas |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 15th, 2006 |
| Last updated | Jul 8th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235201914 | NPPES |
| Wisconsin | Other | 7176-123 | STATE LICENSE |
| Wisconsin | MEDICAID | 4095900 | STATE LICENSE |
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