Clark, Christopher Bruce

Clark, Christopher Bruce is an individual health care provider with primary practice located at 4455 S 108Th St , Greenfield WI 53228-2504. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Clark, Christopher Bruce can be contacted via phone (414) 427-5310.

Contact Information

Primary practice address
4455 S 108Th St Greenfield WI 53228-2504
Phone: (414) 427-5310
Fax: (414) 427-5311
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 8097 Wisconsin

Profile Details

NPI number 1609944693
LBN Legal business name Clark, Christopher Bruce
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2006
Last updated Jan 7th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609944693 NPPES
Wisconsin MEDICAID 1609944693

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