Lacocque, David E.
Lacocque, David E. is an sole proprietor health care provider with primary practice located at 222 S Bedford St Isthmus Psychotherapy, Llc, Madison WI 53703-3688. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Lacocque, David E. can be contacted via phone (608) 256-6570.Contact Information
Primary practice address
222 S Bedford St Isthmus Psychotherapy, Llc
Madison WI 53703-3688
Phone: (608) 256-6570
Fax: (608) 256-4551
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2397057 | Wisconsin |
Profile Details
NPI number | 1134100068 |
---|---|
LBN Legal business name | Lacocque, David E. |
Credentials | PSY.D. |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Nov 8th, 2005 |
Last updated | Mar 15th, 2010 - about 14 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 | 1134100068 | NPPES |
Wisconsin | MEDICAID | 39140500 |
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