Jennifer Elizabeth Strom, M.A., LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4722-125 Issued in WI

Practice address

1317 W Towne Square Rd
Mequon, WI 53092-5017

Phone

(262) 241-5099

NPI assigned

Jan 20, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Jennifer Elizabeth Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Shore Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mequon, WI
  • NPI 1780755389
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1245501345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 W. TOWNE SQUARE",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925017",
            "telephone_number": "262-241-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 W TOWNE SQUARE RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925017",
            "telephone_number": "262-241-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROM",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "M.A., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-20",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "4722-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SMITH",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Don Anthony Stoiber, DDS
• Catherine Ann Stolz, OTR
• Eric L Strande, DC
• Courtney Strauss, MS, LAT, ATC
• Amy Beth Streeter, MSCCCSLP
• Susan Doerflinger Sturdevant, LCSW
• Daniel Andrew Sullivan, DDS
• Elizabeth Gral Sullivan, MS/CCC-SLP
• Melissa J Summerfield, MS, LPC
• Support Plus Personal Care

• Mental Health Counselor in Mequon, WI
• Providers in Mequon, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.