Smith, Mary
Smith, Mary is an sole proprietor health care provider with primary practice located at 1545 S Layton Blvd , Milwaukee WI 53215-1924. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Smith, Mary can be contacted via phone (414) 902-1500.Contact Information
Primary practice address
1545 S Layton Blvd
Milwaukee WI 53215-1924
Phone: (414) 902-1500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | Wisconsin | |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | Wisconsin | |
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | Wisconsin |
Profile Details
| NPI number | 1942412804 |
|---|---|
| LBN Legal business name | Smith, Mary |
| Credentials | M.S.W. CAPSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 4th, 2007 |
| Last updated | Jul 9th, 2007 - about 18 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 | 1942412804 | NPPES |
| Wisconsin | MEDICAID | 40987400 |
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