Juergens, Mark W

Juergens, Mark W is an sole proprietor health care provider with primary practice located at 4330 Golf Ter Suite 214, Eau Claire WI 54701-4683. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Juergens, Mark W can be contacted via phone (715) 833-2121.

Contact Information

Primary practice address
4330 Golf Ter Suite 214 Eau Claire WI 54701-4683
Phone: (715) 833-2121
Fax: (715) 833-2131
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 1839125 Wisconsin

Profile Details

NPI number 1376509588
LBN Legal business name Juergens, Mark W
Credentials LCSW LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 25th, 2006
Last updated May 8th, 2013 - about 13 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 1376509588 NPPES
Wisconsin MEDICAID 40986200
Wisconsin Other 95846
Wisconsin Other 6250399
Wisconsin Other HP52029
Wisconsin Other 574

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