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Individual

MR. EDMUND LEE WEBSTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, LCSW

Contact information

Practice address
631 FOREST ST, WAUSAU, WI 54403-5524
(715) 842-0944
(715) 845-6477
Mailing address
631 FOREST ST, WAUSAU, WI 54403-5524
(715) 842-0944
(715) 845-6477

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2167-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1990
SECURITY HEALTH PLAN
WI
01
225540
MHN
01
280788
VALUEOPLTIONS
05
39571100
WI
01
62743
MULTIPLAN/WPPN
WI
01
P00033788
RAILROAD MEDICARE
01
W010420
CHAMPUS
WI
Enumeration date
07/07/2006
Last updated
09/09/2014
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