Jacqueline Sills, SAC-IT
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · West Milwaukee, WI
NPI 1679944110 · NPPES record last updated Oct 9, 2015
Key facts
- NPI
- 1679944110
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 16689-130 (WI)
- Practice address
- 1610 Miller Park Way
West Milwaukee, WI 53214-3604 - Phone
- (414) 672-3801
- Fax
- (414) 672-6026
- NPI assigned
- Oct 9, 2015
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 16689-130 | WI | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 16689-130 | WI | Yes |
Addresses
Primary practice location
1610 Miller Park Way
West Milwaukee, WI 53214-3604
Mailing address
1610 Miller Park Way
West Milwaukee, WI 53214-3604
Phone (414) 672-3801
Other providers in West Milwaukee, WI
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- Andrea Schneider
- Justin Schwarz
- Karmen W Seltz
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- Tiffany Smith
- Rae Ann Stewart
- Thomas Stocking
- Traci Ann Strait
All providers in West Milwaukee, WI · Addiction (Substance Use Disorder) Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.