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:
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Health care specialties

SpecialtyCodeLicense #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 16 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 1407022692 NPPES
Wisconsin MEDICAID 40981600

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