Ellershaw, Traci
Ellershaw, Traci is an sole proprietor health care provider with primary practice located at 15285 Watertown Plank Rd , Elm Grove WI 53122-2339. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Ellershaw, Traci can be contacted via phone (262) 797-2818.Contact Information
Primary practice address
15285 Watertown Plank Rd
Elm Grove WI 53122-2339
Phone: (262) 797-2818
Fax: (262) 797-2814
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1964-123 | Wisconsin |
Profile Details
| NPI number | 1538310180 |
|---|---|
| LBN Legal business name | Ellershaw, Traci |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 1st, 2008 |
| Last updated | Oct 1st, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538310180 | NPPES |
| Wisconsin | MEDICAID | 39725300 |
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