Rasmussen, Dale S

Rasmussen, Dale S is an individual health care provider with primary practice located at 2640 W Point Rd , Green Bay WI 54304-1344. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Rasmussen, Dale S can be contacted via phone (920) 869-2711.

Contact Information

Primary practice address
2640 W Point Rd Green Bay WI 54304-1344
Phone: (920) 869-2711
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 1308-120 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 10679-132 Wisconsin

Profile Details

NPI number 1609867761
LBN Legal business name Rasmussen, Dale S
Credentials BSW CSAC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2005
Last updated May 13th, 2020 - about 4 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 1609867761 NPPES
Wisconsin MEDICAID 39168800

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