Lacocque, David E.

Lacocque, David E. is an sole proprietor health care provider with primary practice located at 222 S Bedford St Isthmus Psychotherapy, Llc, Madison WI 53703-3688. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Lacocque, David E. can be contacted via phone (608) 256-6570.

Contact Information

Primary practice address
222 S Bedford St Isthmus Psychotherapy, Llc Madison WI 53703-3688
Phone: (608) 256-6570
Fax: (608) 256-4551
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2397057 Wisconsin

Profile Details

NPI number 1134100068
LBN Legal business name Lacocque, David E.
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 8th, 2005
Last updated Mar 15th, 2010 - about 16 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 1134100068 NPPES
Wisconsin MEDICAID 39140500

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