Nicholas Jenquin

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

7636-226 Issued in WI

Practice address

1496 Bellevue St # 101
Green Bay, WI 54311-4205

Phone

(920) 784-2644

Fax

(920) 784-2655

NPI assigned

Sep 21, 2023

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Spectrum Behavioral Health LLC

  • Community/Behavioral Health Agency
  • Green Bay, WI
  • NPI 1053718890
  NPD

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

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1821876608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1496 BELLEVUE ST # 101",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114205",
            "telephone_number": "920-784-2644",
            "fax_number": "920-784-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1496 BELLEVUE ST # 101",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114205",
            "telephone_number": "920-784-2644",
            "fax_number": "920-784-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENQUIN",
        "first_name": "NICHOLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-21",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "7636-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shirley M Jean-Baptiste, APNP
• Taylor Nicole Jean, CHWC, NBHWC, CPT
• Eric L. Jenison, M.D.
• John W Jenkins, PA-C
• Rebecca Jenkins, PA-C
• Benjamin James Jensen, MD
• Jennifer Marie Jensen, AGPC-NP
• Megan M Jensen, LPC
• Richard Edmund Jensen, D.D.S.
• Robert Edmund Jensen, DPT

• Mental Health Counselor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.