Mayo, Peter L

Mayo, Peter L is an sole proprietor health care provider with primary practice located at 130 Main Street Suite 200, Menasha WI 54952. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Mayo, Peter L can be contacted via phone (920) 379-7769.

Contact Information

Primary practice address
130 Main Street Suite 200 Menasha WI 54952
Phone: (920) 379-7769
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 3461-125 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 15332-132 Wisconsin

Profile Details

NPI number 1154529196
LBN Legal business name Mayo, Peter L
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 10th, 2007
Last updated Jul 7th, 2016 - about 8 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 1154529196 NPPES
Wisconsin MEDICAID 40969100

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