Psychiatric & Psychotherapy Clinic L I Newman Md Sc Gen Ptr
LBN: Psychiatric & Psychotherapy Clinic L I Newman Md Sc Gen Ptr
Psychiatric & Psychotherapy Clinic L I Newman Md Sc Gen Ptr is an health care organization with primary practice located at 3601 30Th Ave Ste 102 , Kenosha WI 53144-1642. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Allopathic & Osteopathic Physicians / Addiction Medicine. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is the primary health care specialty.
Psychiatric & Psychotherapy Clinic L I Newman Md Sc Gen Ptr can be contacted via phone (262) 654-0487, or through Defazio, Paul M via phone (262) 654-0487.
Contact Information
Primary practice address
3601 30Th Ave Ste 102
Kenosha WI 53144-1642
Phone: (262) 654-0487
Fax: (262) 654-2434
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | ||
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 103TA0400X | ||
| Allopathic & Osteopathic Physicians / Addiction Medicine | 2084A0401X |
Profile Details
| NPI number | 1932312212 |
|---|---|
| LBN Legal business name | Psychiatric & Psychotherapy Clinic L I Newman Md Sc Gen Ptr |
| DBA Doing business as | |
| Authorized official | Defazio, Paul M |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 7th, 2007 |
| Last updated | Aug 11th, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932312212 | NPPES |
| Wisconsin | MEDICAID | 42124700 |
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