Bascom, Jeanne

Bascom, Jeanne is an individual health care provider with primary practice located at W156N8327 Pilgrim Rd , Menomonee Falls WI 53051-3776. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Bascom, Jeanne can be contacted via phone (262) 251-1112.

Contact Information

Primary practice address
W156N8327 Pilgrim Rd Menomonee Falls WI 53051-3776
Phone: (262) 251-1112
Fax: (262) 251-1113
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 11174 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 3339-123 Wisconsin

Profile Details

NPI number 1487675575
LBN Legal business name Bascom, Jeanne
Credentials MSW, LCSW, CADC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2006
Last updated Dec 3rd, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487675575 NPPES
Wisconsin MEDICAID 40925700

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