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NPI Code Detail

MEDICARE: LISA SACHS MSW

MEDICARE: LISA SACHS MSW
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
11041C0700XClinical Social Worker6976-123WI
21041C0700XClinical Social WorkerIL

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 : 1700811965
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA SACHS MSW
Provider Business Mailing Address
First Line : 4109 67TH ST
Second Line :
City : KENOSHA
State : WI
Zip : 53142-3836
Country : US
Telephone Number : 262-652-9830
Fax Number : 262-652-2931
Provider Business Practice Location Address
First Line : 4109 67TH ST
Second Line :
City : KENOSHA
State : WI
Zip : 53142-3836
Country : US
Telephone Number : 262-652-9830
Fax Number : 262-652-2931
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 07/08/2007

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Directions to “ LISA SACHS MSW” Practice Location

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