Modell, Craig Alan
Modell, Craig Alan is an individual health care provider with primary practice located at 10229 W Greenfield Ave , West Allis WI 53214. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Modell, Craig Alan can be contacted via phone (414) 453-6330.Contact Information
Primary practice address
10229 W Greenfield Ave
West Allis WI 53214
Phone: (414) 453-6330
Fax: (414) 453-6523
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 696057 | Wisconsin |
Profile Details
| NPI number | 1366552887 |
|---|---|
| LBN Legal business name | Modell, Craig Alan |
| Credentials | PHD PSYCHOLOGIST |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366552887 | NPPES |
| Wisconsin | MEDICAID | 39097200 |
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