| Cynthia Leigh Carlson Llc | |
|
3970 N Oakland Ave Ste 704 Shorewood WI 53211-2265 | |
| (414) 963-9187 | |
| Not Available |
| Full Name | Cynthia Leigh Carlson Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3970 N Oakland Ave Ste 704, Shorewood, Wisconsin |
| Authorized Official Name and Position | Cynthia Leigh Carlson (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 4149639187 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cynthia Leigh Carlson Llc 3970 N Oakland Ave Ste 704 Shorewood WI 53211-2265 Ph: (414) 963-9187 | Cynthia Leigh Carlson Llc 3970 N Oakland Ave Ste 704 Shorewood WI 53211-2265 Ph: (414) 963-9187 |
| NPI Number | 1023302767 |
|---|---|
| Provider Enumeration Date | 05/28/2011 |
| Last Update Date | 09/12/2011 |
| Medicare PECOS PAC ID | 6901075241 |
|---|---|
| Medicare Enrollment ID | O20110803000338 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023302767 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2706 (Wisconsin) | Primary |
| Provider Name | Cynthia L Carlson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578680393 PECOS PAC ID: 8325217680 Enrollment ID: I20110803000502 |
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