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NPI Code Detail

MEDICARE: MS. SHERYL ANNE MARTIN BS CSAC

MEDICARE: MS. SHERYL ANNE MARTIN BS CSAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor914 132WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598788473
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHERYL ANNE MARTIN BS CSAC
Provider Business Mailing Address
First Line : 255 W BROADWAY
Second Line :
City : WAUKESHA
State : WI
Zip : 53186-4832
Country : US
Telephone Number : 262-420-9088
Fax Number :
Provider Business Practice Location Address
First Line : 255 W BROADWAY
Second Line :
City : WAUKESHA
State : WI
Zip : 53186-4832
Country : US
Telephone Number : 262-420-9088
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 03/29/2024

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