Janna Lynn Hack, LCSW
Individual provider Active NPI Clinical Social Worker · Edgerton, WI
NPI 1780700708 · NPPES record last updated Apr 28, 2011
Key facts
- NPI
- 1780700708
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 7174-123 (WI)
- Practice address
- 302 S. Main St.
Edgerton, WI 53534 - Phone
- (608) 239-7648
- NPI assigned
- Mar 21, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 7174-123 | WI | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 7174-123 | WI | Yes |
Addresses
Primary practice location
302 S. Main St.
Edgerton, WI 53534
Mailing address
302 S. Main St.
Edgerton, WI 53534
Phone (608) 239-7648
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40933900 | Medicaid | WI |
Other providers in Edgerton, WI
- David P Gorski
- Nathan Greengus
- Eric Robert Gresens
- Jenna N Gresens
- William Gurske
- Angela M Hagen
- Heather Hoefen DC Inc
- Paul Herrlinger
- Heather Hoefen
- Robert A Hoefler
All providers in Edgerton, WI · Clinical Social Worker in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2011. 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.