Poe, Martin James

Poe, Martin James is an sole proprietor health care provider with primary practice located at 5200 Washington Ave Suite 203, Racine WI 53406-4238. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Family. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Poe, Martin James can be contacted via phone (262) 763-7249.

Contact Information

Primary practice address
5200 Washington Ave Suite 203 Racine WI 53406-4238
Phone: (262) 763-7249
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1302 Wisconsin
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 1302 Wisconsin
Behavioral Health & Social Service Providers / Family 103TF0000X 1302 Wisconsin

Profile Details

NPI number 1558577395
LBN Legal business name Poe, Martin James
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 16th, 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 1558577395 NPPES
Wisconsin MEDICAID 39083800

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