Primus, Sally Ann
Primus, Sally Ann is an individual health care provider with primary practice located at 3176 Lancer St Suite 501, Portage IN 46368. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Primus, Sally Ann can be contacted via phone (219) 762-9557.Contact Information
Primary practice address
3176 Lancer St Suite 501
Portage IN 46368
Phone: (219) 762-9557
Fax: (219) 762-7318
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 99027928A | Indiana |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 34006144A | Indiana |
Profile Details
| NPI number | 1225228828 |
|---|---|
| LBN Legal business name | Primus, Sally Ann |
| Credentials | MSW, LCSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 30th, 2007 |
| Last updated | Jul 27th, 2011 - about 14 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 | 1225228828 | NPPES |
| Indiana | MEDICAID | 10016380A |
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