Radke, Michael R

Radke, Michael R is an individual health care provider with primary practice located at 920 60Th St , Kenosha WI 53140-4041. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Radke, Michael R can be contacted via phone (262) 654-5333.

Contact Information

Primary practice address
920 60Th St Kenosha WI 53140-4041
Phone: (262) 654-5333
Fax: (262) 654-7818
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 223-123 Wisconsin

Profile Details

NPI number 1235290438
LBN Legal business name Radke, Michael R
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
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 1235290438 NPPES
Other 137813 MANAGED HEALTH NETWORK
Other 166371 MANAGED HEALTH NETWORK
MEDICAID 39501700 MANAGED HEALTH NETWORK
Other 5142131 MANAGED HEALTH NETWORK
Other 79962 MANAGED HEALTH NETWORK
Other W007066 MANAGED HEALTH NETWORK

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