Tegtmeier, Mark Alan

Tegtmeier, Mark Alan is an sole proprietor health care provider with primary practice located at E7475 Rawhide Rd , New London WI 54961. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Tegtmeier, Mark Alan can be contacted via phone (920) 982-6100.

Contact Information

Primary practice address
E7475 Rawhide Rd New London WI 54961
Phone: (920) 982-6100
Fax: (920) 982-5040
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 1863-125 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 2364-123 Wisconsin
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 479-124 Wisconsin

Profile Details

NPI number 1821263849
LBN Legal business name Tegtmeier, Mark Alan
Credentials MA, LCSW, LPC, LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 30th, 2008
Last updated Apr 30th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821263849 NPPES
Wisconsin MEDICAID 39273400

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