DAVID KLIMISCH LPC INC NPI 1790328763

NPI Information

NPI: 1790328763
Provider Name: DAVID KLIMISCH LPC INC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
6123 GREEN BAY RD STE 240
KENOSHA, WI
ZIP 53142
Phone: (262) 564-5305
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DAVID KLIMISCH LPC INC is a mental health (including community mental health center) clinic center in Kenosha, WI. DAVID KLIMISCH LPC INC NPI is 1790328763. The provider is registered as an organization entity type.

The provider's business location address is:

6123 GREEN BAY RD STE 240
KENOSHA, WI
ZIP 53142-927
Phone: (262) 564-5305
Fax: (262) 564-5306

The provider's authorized official is David J. Klimisch .
The authorized official title is President and has the following contact phone number (262) 564-5305.

The enumeration date for this NPI number is 10/23/2019 and was last updated on 10/23/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1427544337	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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