Jenna L Walstead, SAC-IT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

19298-130 Issued in WV

Practice address

2914 Industrial Dr
Madison, WI 53713-4047

Phone

(608) 223-3311

NPI assigned

Sep 9, 2021

Sex

Female

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

State licenses

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1336818616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 N PLEASANT ST",
            "city": "CAMBRIDGE",
            "state": "WI",
            "postal_code": "535239404",
            "telephone_number": "608-843-7966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2914 INDUSTRIAL DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537134047",
            "telephone_number": "608-223-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSTEAD",
        "first_name": "JENNA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "SAC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WV",
            "license": "19298-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen M Walsh, NP
• Jessica Diane Walsh, MS, OTR/L
• Kathleen Walsh, DO
• Kevin Walsh, R.N.
• Michael B Walsh, DO
• Amanda Elizabeth Walter, PHARMD
• Mackenzie Walter
• Martha June Walter, PH.D
• Amy Walters
• Beth Walters, MD

• Addiction (Substance Use Disorder) Counselor in Madison, WI
• Providers in Madison, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.