Conway, Elaine Therese

Conway, Elaine Therese is an individual health care provider with primary practice located at 934 S Clay St , Green Bay WI 54301-3419. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Conway, Elaine Therese can be contacted via phone (920) 819-6570.

Contact Information

Primary practice address
934 S Clay St Green Bay WI 54301-3419
Phone: (920) 819-6570
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 3537-125 Wisconsin

Profile Details

NPI number 1770776429
LBN Legal business name Conway, Elaine Therese
Credentials MS, LPC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2007
Last updated Sep 18th, 2008 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770776429 NPPES
Wisconsin MEDICAID 40953300

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