Shaquan L Jefferson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5428-226 Issued in WI

Practice address

5600 W Brown Deer Rd
Brown Deer, WI 53223-2311

Phone

(414) 446-8154

NPI assigned

Oct 18, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• A Key to the Streets Foundation Inc.

  • Mental Health Counselor
  • Milwaukee, WI
  • NPI 1992410500
  NPD Authorized official

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1245956424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 W BROWN DEER RD",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532232311",
            "telephone_number": "414-446-8154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 W BROWN DEER RD",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532232311",
            "telephone_number": "414-446-8154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "SHAQUAN",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "5428-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freeman Jackson Jr.
• Virginia Abraham Jagla, M.S. CCC-SLP
• Abigail Jameson
• Jeanne H Jeanphilippe
• Darolyn Dobs Jedrzejczak, MS
• Kristin Lynne Jessee, LPC-IT
• JFS Housing Inc
• Kristin Ann Johnson, MS LPC
• Marniece Johnson, PSYD
• Michael F Johnstone, MD

• Mental Health Counselor in Brown Deer, WI
• Providers in Brown Deer, 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 Oct 18, 2022; 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.