Wilsusen, Michelle

Wilsusen, Michelle is an individual health care provider with primary practice located at 2277 Grand Ave , Baldwin NY 11510-3148. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Wilsusen, Michelle can be contacted via phone (516) 377-5400.

Contact Information

Primary practice address
2277 Grand Ave Baldwin NY 11510-3148
Phone: (516) 377-5400
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 078022 New York
Behavioral Health & Social Service Providers / Social Worker 104100000X 076326 New York

Profile Details

NPI number 1992032593
LBN Legal business name Wilsusen, Michelle
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 3rd, 2009
Last updated Nov 27th, 2012 - about 12 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 1992032593 NPPES
New York MEDICAID 01764850

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