Jackett, Andrea K

Jackett, Andrea K is an individual health care provider with primary practice located at 2424 S 90Th St , West Allis WI 53227-2455. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Jackett, Andrea K can be contacted via phone (414) 328-8700.

Contact Information

Primary practice address
2424 S 90Th St West Allis WI 53227-2455
Phone: (414) 328-8700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Professional 101YP2500X 4796 Wisconsin
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 4796 Wisconsin

Profile Details

NPI number 1932422953
LBN Legal business name Jackett, Andrea K
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 4th, 2010
Last updated Nov 18th, 2024 - about 2 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 1932422953 NPPES
Wisconsin MEDICAID 100186980

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