Lipford, Charles D

Lipford, Charles D is an sole proprietor health care provider with primary practice located at 220 E La Crosse St. Juneau County Human Services, Mauston WI 53948-2101. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Lipford, Charles D can be contacted via phone (608) 847-2400.

Contact Information

Primary practice address
220 E La Crosse St. Juneau County Human Services Mauston WI 53948-2101
Phone: (608) 847-2400
Fax: (608) 847-9599
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 302375 Minnesota
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 15413-131 Wisconsin

Profile Details

NPI number 1003079708
LBN Legal business name Lipford, Charles D
Credentials CSAC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 3rd, 2008
Last updated Jun 30th, 2009 - about 17 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 1003079708 NPPES
Wisconsin MEDICAID 1003079708

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