Goedken, Ann M
Goedken, Ann M is an sole proprietor health care provider with primary practice located at 747B Crawford Dr , Cottage Grove WI 53527-9671. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Goedken, Ann M can be contacted via phone (608) 839-1979.Contact Information
Primary practice address
747B Crawford Dr
Cottage Grove WI 53527-9671
Phone: (608) 839-1979
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | 201-125 | Wisconsin |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 790-123 | Wisconsin |
Profile Details
| NPI number | 1003081084 |
|---|---|
| LBN Legal business name | Goedken, Ann M |
| Credentials | MS, LCSW,LPC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 29th, 2008 |
| Last updated | Apr 29th, 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 | 1003081084 | NPPES |
| Wisconsin | MEDICAID | 39669100 |
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