Cardinal, Amanda R
Cardinal, Amanda R is an sole proprietor health care provider with primary practice located at 123 N Oakland Ave , Green Bay WI 54303-2831. She recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Cardinal, Amanda R can be contacted via phone (920) 770-4088.Contact Information
Primary practice address
123 N Oakland Ave
Green Bay WI 54303-2831
Phone: (920) 770-4088
Fax: (651) 705-0026
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) | 261QM0801X | 6319-125 | Wisconsin |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 6319 | Wisconsin |
Profile Details
| NPI number | 1265969950 |
|---|---|
| LBN Legal business name | Cardinal, Amanda R |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 12th, 2017 |
| Last updated | Apr 23rd, 2024 - about 2 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 | 1265969950 | NPPES |
| Wisconsin | MEDICAID | 100068903 |
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