Mack, Kathleen Rose
Mack, Kathleen Rose is an individual health care provider with primary practice located at 5555 N Port Washington Rd Ste 200 , Glendale WI 53217-4927. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Mack, Kathleen Rose can be contacted via phone (262) 789-1191.Contact Information
Primary practice address
5555 N Port Washington Rd Ste 200
Glendale WI 53217-4927
Phone: (262) 789-1191
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 9613-123 | Wisconsin |
Profile Details
NPI number | 1619560992 |
---|---|
LBN Legal business name | Mack, Kathleen Rose |
Credentials | Licensed Clinical Social Worker (LCSW) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 17th, 2021 |
Last updated | Feb 17th, 2021 - about 3 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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