Mickulick, Walter J

Mickulick, Walter J is an sole proprietor health care provider with primary practice located at 5600 Brainerd Rd Ste B42 , Chattanooga TN 37411-5356. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Forensic is his primary health care specialty. Mickulick, Walter J can be contacted via phone (423) 605-1855.

Contact Information

Primary practice address
5600 Brainerd Rd Ste B42 Chattanooga TN 37411-5356
Phone: (423) 605-1855
Fax: (423) 296-6515
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 101YS0200X 7147485 Tennessee
Behavioral Health & Social Service Providers / Clinical 103TC0700X 7137531 Tennessee
Behavioral Health & Social Service Providers / Forensic 103TF0200X 7696871 Tennessee
Behavioral Health & Social Service Providers / School 103TS0200X 7147485 Tennessee

Profile Details

NPI number 1043578123
LBN Legal business name Mickulick, Walter J
Credentials M.A., MPA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 26th, 2012
Last updated Apr 26th, 2012 - about 12 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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