Kim M Davis-Rislove, MSSW LCSW

Individual provider Active NPI Clinical Social Worker · Arcadia, WI

NPI 1114969607 · NPPES record last updated May 21, 2019

Key facts

NPI
1114969607
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
3356 (WI)
Practice address
895 Dettloff Dr
Arcadia, WI 54612-2600
Phone
(608) 785-0940
NPI assigned
Jun 11, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3356 WI Yes

Addresses

Primary practice location

895 Dettloff Dr
Arcadia, WI 54612-2600

Mailing address

PO Box 1510
Eau Claire, WI 54702-1510
Phone (608) 785-0940

Other practice location 1

464 S Saint Joseph Ave
Arcadia, WI 54612-1401
Phone (608) 323-3341

Other providers in Arcadia, WI

All providers in Arcadia, WI · Clinical Social Worker in Wisconsin

Sources for this page

Verify at the official NPI Registry.