Jorgensen, Donna

Jorgensen, Donna is an sole proprietor health care provider with primary practice located at 815 57Th St Unit I , Kenosha WI 53140-4062. 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 / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Jorgensen, Donna can be contacted via phone (262) 354-7159.

Contact Information

Primary practice address
815 57Th St Unit I Kenosha WI 53140-4062
Phone: (262) 354-7159
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 16217-132 Wisconsin
Behavioral Health & Social Service Providers / Professional 101YP2500X 705-125 Wisconsin

Profile Details

NPI number 1326416355
LBN Legal business name Jorgensen, Donna
Credentials LPC, CSAC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 8th, 2015
Last updated Jan 14th, 2020 - about 6 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 1326416355 NPPES
Wisconsin MEDICAID 1326416355
Wisconsin Other 1326416355

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