Eklund, Mark R

Eklund, Mark R is an individual health care provider with primary practice located at 1325 Angels Path Rd , De Pere WI 54115-4050. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Eklund, Mark R can be contacted via phone (920) 338-2855.

Contact Information

Primary practice address
1325 Angels Path Rd De Pere WI 54115-4050
Phone: (920) 338-2855
Fax: (920) 338-9270
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 485-124 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 1501-123 Wisconsin

Profile Details

NPI number 1124030770
LBN Legal business name Eklund, Mark R
Credentials LCSW,MFT
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2006
Last updated Apr 10th, 2019 - about 6 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 1124030770 NPPES
Wisconsin MEDICAID 39342800

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