Smith, Chris
Smith, Chris is an individual health care provider with primary practice located at 121 W Main St , Port Washington WI 53074-0994. He recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as his primary health care specialty. Smith, Chris can be contacted via phone (262) 284-8200.Contact Information
Primary practice address
121 W Main St
Port Washington WI 53074-0994
Phone: (262) 284-8200
Fax: (262) 284-8104
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 68124 | Wisconsin |
Profile Details
NPI number | 1407022692 |
---|---|
LBN Legal business name | Smith, Chris |
Credentials | MDIV LMFT |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 7th, 2008 |
Last updated | May 7th, 2008 - 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1407022692 | NPPES |
Wisconsin | MEDICAID | 40981600 |
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