Pangrazzi, Cody A
Pangrazzi, Cody A is an individual health care provider with primary practice located at 4061 Old Peshtigo Rd , Marinette WI 54143-3887. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Pangrazzi, Cody A can be contacted via phone (715) 732-8000.Contact Information
Primary practice address
4061 Old Peshtigo Rd
Marinette WI 54143-3887
Phone: (715) 732-8000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 130736 | Wisconsin |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 9204 | Wisconsin |
Profile Details
| NPI number | 1295259596 |
|---|---|
| LBN Legal business name | Pangrazzi, Cody A |
| Credentials | LPSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 28th, 2017 |
| Last updated | Dec 13th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295259596 | NPPES |
| Wisconsin | MEDICAID | 100069692 |
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