Jennifer Everts, LPC

Individual provider Active NPI Professional Counselor · Hartford, WI

NPI 1104351840 · NPPES record last updated May 1, 2017

Key facts

NPI
1104351840
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
6465-125 (WI)
Practice address
620 Pleasant Ave
Hartford, WI 53027-1955
Phone
(262) 457-1121
NPI assigned
May 1, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6465-125WIMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6465-125 WI Yes

Addresses

Primary practice location

620 Pleasant Ave
Hartford, WI 53027-1955

Mailing address

620 Pleasant Ave
Hartford, WI 53027-1955
Phone (262) 457-1121

Other providers in Hartford, WI

All providers in Hartford, WI · Professional Counselor in Wisconsin

Sources for this page

Verify at the official NPI Registry.