Shea, Nancy
Shea, Nancy is an individual health care provider with primary practice located at 200 E Tyranena Park Rd , Lake Mills WI 53551-9678. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Shea, Nancy can be contacted via phone (920) 648-8393.Contact Information
Primary practice address
200 E Tyranena Park Rd
Lake Mills WI 53551-9678
Phone: (920) 648-8393
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1697 | Wisconsin |
Profile Details
| NPI number | 1265420491 |
|---|---|
| LBN Legal business name | Shea, Nancy |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 11th, 2005 |
| Last updated | May 4th, 2021 - about 3 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 | 1265420491 | NPPES |
| Wisconsin | MEDICAID | 39634600 | |
| Wisconsin | Other | 1011361 |
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