Mayor, Nicholas R

Mayor, Nicholas R is an individual health care provider with primary practice located at 3535 30Th Avenue Suite 202, Kenosha WI 53144. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Mayor, Nicholas R can be contacted via phone (262) 842-0500.

Contact Information

Primary practice address
3535 30Th Avenue Suite 202 Kenosha WI 53144
Phone: (262) 842-0500
Fax: (262) 842-0502
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 12318 Wisconsin
Behavioral Health & Social Service Providers / Professional 101YP2500X 1681-125 Wisconsin

Profile Details

NPI number 1831103761
LBN Legal business name Mayor, Nicholas R
Credentials MA LPC SAC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Jun 20th, 2008 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831103761 NPPES
Wisconsin MEDICAID 39635400

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