Peterson, James

Peterson, James is an individual health care provider with primary practice located at 152 E State St , Burlington WI 53105-1940. He recently has 3 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 / Clinical. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Peterson, James can be contacted via phone (262) 763-8183.

Contact Information

Primary practice address
152 E State St Burlington WI 53105-1940
Phone: (262) 763-8183
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 2095 Wisconsin
Behavioral Health & Social Service Providers / Professional 101YP2500X 1610 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 4101 Wisconsin

Profile Details

NPI number 1245353770
LBN Legal business name Peterson, James
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2007
Last updated Jul 8th, 2007 - 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 1245353770 NPPES
Wisconsin MEDICAID 10908200

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