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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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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