Lodl, Charles Mathew
Lodl, Charles Mathew is an sole proprietor health care provider with primary practice located at 11501 N Port Washington Rd Suite 210, Mequon WI 53092-3466. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Lodl, Charles Mathew can be contacted via phone (262) 241-8901.Contact Information
Primary practice address
11501 N Port Washington Rd Suite 210
Mequon WI 53092-3466
Phone: (262) 241-8901
Fax: (262) 241-8907
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 857-057 | Wisconsin |
Profile Details
| NPI number | 1033132899 |
|---|---|
| LBN Legal business name | Lodl, Charles Mathew |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 25th, 2006 |
| Last updated | Jul 8th, 2007 - 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 | 1033132899 | NPPES |
| Wisconsin | MEDICAID | 39050600 |
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