Jacobs, Jill

Jacobs, Jill is an sole proprietor health care provider with primary practice located at 5007 S Howell Ave Ste 350 , Milwaukee WI 53207-6159. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Jacobs, Jill can be contacted via phone (262) 789-1191.

Contact Information

Primary practice address
5007 S Howell Ave Ste 350 Milwaukee WI 53207-6159
Phone: (262) 789-1191
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2370-125 Wisconsin
Behavioral Health & Social Service Providers / School 101YS0200X 173951 Wisconsin

Profile Details

NPI number 1154704559
LBN Legal business name Jacobs, Jill
Credentials M.S., LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 2nd, 2015
Last updated Jul 2nd, 2015 - about 11 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 1154704559 NPPES
Wisconsin MEDICAID 42170300

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