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NPI Code Detail

MEDICARE: MRS. MARY ELIZABETH KLAHR CSAC

MEDICARE: MRS. MARY ELIZABETH KLAHR 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) Counselor11342-132WI
2104100000XSocial Worker6198-120WI

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 : 1689847964
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY ELIZABETH KLAHR CSAC
Provider Business Mailing Address
First Line : 3801 N 88TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53222-2706
Country : US
Telephone Number : 414-466-9450
Fax Number : 414-466-0730
Provider Business Practice Location Address
First Line : 3801 N 88TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53222-2706
Country : US
Telephone Number : 414-466-9450
Fax Number : 414-466-0730
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2008
Last Update Date : 04/08/2008

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