Jorgensen, Don A
Jorgensen, Don A is an individual health care provider with primary practice located at 515 22Nd Ave , Monroe WI 53566-1569. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Jorgensen, Don A can be contacted via phone (608) 324-2770.Contact Information
Primary practice address
515 22Nd Ave
Monroe WI 53566-1569
Phone: (608) 324-2770
Fax: (608) 324-2469
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 2522-123 | Wisconsin |
Profile Details
| NPI number | 1417094038 |
|---|---|
| LBN Legal business name | Jorgensen, Don A |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 31st, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417094038 | NPPES |
| Wisconsin | MEDICAID | 39672400 |
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