Jill M. Wollenzien-Daniels, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2273-057 Issued in WI

Practice address

2290 Rickie Dr
Mosinee, WI 54455-8848

Phone

(715) 298-2104

NPI assigned

Feb 1, 2007

Last updated

Feb 11, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 8

Addresses

Other identifiers 1

Other names 1

• Dr. Jill Daniels Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Milwaukee

  • Psychiatry Physician
  • Milwaukee, WI
  • NPI 1831256353
  NPD (past)

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234310400000",
    "number": "1730227885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 RICKIE DR",
            "city": "MOSINEE",
            "state": "WI",
            "postal_code": "544558848",
            "telephone_number": "715-298-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 RICKIE DR",
            "city": "MOSINEE",
            "state": "WI",
            "postal_code": "544558848",
            "telephone_number": "715-298-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLENZIEN-DANIELS",
        "first_name": "JILL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2009-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2273-057",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "2273-057",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "WI",
            "license": "2273-057",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "WI",
            "license": "2273-057",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2273-057",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "WI",
            "license": "2273-057",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "WI",
            "license": "2273-057",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "WI",
            "license": "2273-057",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39274400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "DANIELS",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Richelle Welch
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• Kevin S. Wianecki, D.C.
• Wisconsin Lutheran Child & Family Service (Christian Family Counseling)
• Darrell Witt, MD
• Jane M Ziemanski, NP
• Susan G Zimbric, MD

• Clinical Psychologist in Mosinee, WI
• Providers in Mosinee, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; 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.