Interpersonnel

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4026123 Issued in WI

Legal business name

INTERPERSONNEL

Practice address

401 Wisconsin Ave
Madison, WI 53703-1487

Phone

(608) 345-2273

Fax

(608) 256-5116

NPI assigned

May 15, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Holly Jorgenson, LCSW

Title

Owner

Phone

(608) 345-2273

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400112000000",
    "number": "1861803512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 COMMONWEALTH AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537265301",
            "telephone_number": "608-345-2273",
            "fax_number": "608-256-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 WISCONSIN AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537031487",
            "telephone_number": "608-345-2273",
            "fax_number": "608-256-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERPERSONNEL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-15",
        "last_updated": "2014-05-15",
        "status": "A",
        "authorized_official_last_name": "JORGENSON",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-345-2273",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "4026123",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4026126",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659452571",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Madison, WI
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• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; 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.