Pederson-Lewis, Ellen Claire

Pederson-Lewis, Ellen Claire is an individual health care provider with primary practice located at 675 N Brookfield Rd Ste 101, Brookfield WI 53045-5858. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Pederson-Lewis, Ellen Claire can be contacted via phone (262) 641-9300.

Contact Information

Primary practice address
675 N Brookfield Rd Ste 101 Brookfield WI 53045-5858
Phone: (262) 641-9300
Fax: (262) 641-9307
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 1679-123 Wisconsin
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 401-124 Wisconsin

Profile Details

NPI number 1649306317
LBN Legal business name Pederson-Lewis, Ellen Claire
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 26th, 2007
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649306317 NPPES
Wisconsin MEDICAID 39296900

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