Provider Demographics
NPI:1497398150
Name:MCNAMARA, DAN (CSAC)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:
Last Name:MCNAMARA
Suffix:
Gender:M
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 E MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:BARRON
Mailing Address - State:WI
Mailing Address - Zip Code:54812-1479
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:335 E MONROE AVE
Practice Address - Street 2:
Practice Address - City:BARRON
Practice Address - State:WI
Practice Address - Zip Code:54812-1479
Practice Address - Country:US
Practice Address - Phone:715-537-6341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI16161132Medicaid