Andrew James Jacobchick, BA, SAC-IT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

820 Hwy 67
Kiel, WI 53042-1627

Phone

(920) 797-4457

Fax

(920) 894-1373

NPI assigned

Mar 19, 2020

Sex

Male

Sole proprietor

No

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

Credentials

Bachelor of Arts

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1265068415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 HWY 67",
            "city": "KIEL",
            "state": "WI",
            "postal_code": "530421627",
            "telephone_number": "920-797-4457",
            "fax_number": "920-894-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 HWY 67",
            "city": "KIEL",
            "state": "WI",
            "postal_code": "530421627",
            "telephone_number": "920-797-4457",
            "fax_number": "920-894-1373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBCHICK",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "credential": "BA, SAC-IT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-19",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Robin Herziger, P.T.
• Michael H Hetzner, DO
• Jessica Hoefler
• Kristen D Holzwart, MSN, APNP, FNP-C
• Jessica Hoppa, RN
• Eman Wja Jammali
• Jeffrey Lee Janikowski, CSAC
• Cary A Johannes, PSYD
• Pamela Ann Kachelmeier, MA, PC (EAMH)
• Barbara Lynn Karls, DDS

• All providers in Kiel, WI
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.