MISS JESSICA LARSON (NPI# 1104232800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104232800 |
| Entity Type | Individual |
| Full Name | MISS JESSICA LARSON |
| Other Name | JESSICA LENZ |
| Credential | BS, BS, MAFP, CSAC |
| Practice Address |
230 W Wells St Ste 312 Milwaukee WI 53203-1837 |
| Practice Telephone | 4143443406 |
| Practice Fax Number | 4143440107 |
| Mailing Telephone | 4143443406 |
| Mailing Fax Number | 4143440107 |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2016-04-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
16009-132 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100055295 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770096265 | Jessica Lee Larson | Speech-Language Pathologist | 4183 Sunnyslope Rd Sw, Port Orchard, WA 98367-7677 | 2017-11-07 |
| 1205214731 | Jessica Larson | Specialist/Technologist | W3173 County Road Pp, Sheboygan Falls, WI 53085-2533 | 2015-05-17 |
| 1780200238 | Jessica Lynn Larson | Student in an Organized Health Care Education/Training Program | 982055 Nebraska Medical Ctr, Omaha, NE 68198-2055 | 2020-06-21 |
| 1023646528 | Jessica Larson | Behavior Technician | 9167 W Flamingo Rd, Las Vegas, NV 89147-6472 | 2020-03-30 |
| 1891254298 | Jessica Larson | Occupational Therapist | 199 Shunpike Rd, Cromwell, CT 06416-1142 | 2019-03-15 |
| 1609377647 | Jessica Ann Larson | Physical Therapist | 235 Wealthy St Se, Grand Rapids, MI 49503-5247 | 2018-02-26 |
| 1629427018 | Jessica Larson | Dietitian, Registered | 6401 France Ave S, Southdale Hospital Ll10, Edina, MN 55435-2104 | 2016-06-07 |
| 1811391246 | Jessica Larson | Pharmacist | 2564 Barataria Blvd, Marrero, LA 70072-5304 | 2014-10-14 |
| 1558774844 | Jessica Larson | Counselor | 1255 Pearl St, #102, Eugene, OR 97401-3570 | 2014-06-04 |
| 1356777932 | Jessica B Larson | Physical Therapist | 4150 Clement St, San Francisco, CA 94121-1545 | 2013-09-16 |
| Street Address |
230 W WELLS ST STE 312 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53203-1837 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831497114 | Yezlin Denae Kelly | Counselor | 230 W Wells St Ste 312, Milwaukee, WI 53203-1837 | 2011-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013463272 | Kameela Jackson | Registered Nurse | 606 E Juneaue Ave. 511812, Milwaukee, WI 53203 | 2016-08-28 |
| 1528239928 | Christina Marie Sauber | Physical Therapy Assistant | 111 W. Michigan Street, Milwaukee, WI 53203 | 2008-03-13 |
| 1720273493 | Michelle Lynn Vogel | Speech-Language Pathologist | 111 West Michigan St, Prostep/extendicare Healthservices, Milwaukee, WI 53203 | 2007-09-06 |
| 1265572564 | Eye Care of Wisconsin, Inc | Health Maintenance Organization | 740 North Plankinton Ave, #730b, Milwaukee, WI 53203 | 2007-02-07 |
| 1073687349 | Riverwalk Psychotherapy Associates, LLC | Social Worker | 1110 N. Old World Third St., Suite 401, Milwaukee, WI 53203 | 2006-11-20 |
| 1144793423 | Carissa Deanna Basile | Behavioral Analyst | 525 N 6th St, Milwaukee, WI 53203 | 2019-01-09 |
| 1275975807 | Sandra Eiler | Counselor | 633 W Wisconsin Ave, Suite 1810, Milwaukee, WI 53203 | 2013-07-24 |
| 1154693331 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 826 N Plankinton Ave Ste 100, Milwaukee, WI 53203 | 2012-02-02 |
| 1821277310 | Rosalie C Mackay | Community Health Worker | 111 W Michigan St, Prostep/extendicare Health Services, Milwaukee, WI 53203 | 2007-10-31 |
| 1023131240 | Gina G Negrette | Psychiatry & Neurology | 820 N Plankinton Ave, Milwaukee, WI 53203 | 2007-04-10 |
| Find all providers in zip 53203 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649879982 | Veronicia S Green | Counselor | 2821 N Vel R Phillips Ave Ste 131, Milwaukee, WI 53212-2370 | 2020-10-19 |
| 1932733193 | 1 Step Away Divine Counseling Service LLC | Counselor | 6815 W Capitol Dr Ste 308, Milwaukee, WI 53216-2056 | 2020-02-26 |
| 1689216293 | Carollyn Black | Counselor | 4892 N 19th St, Milwaukee, WI 53209-5757 | 2019-10-15 |
| 1861046146 | Lisa Marie Ortiz | Counselor | 3336 S 76th St, Milwaukee, WI 53219-3805 | 2019-07-25 |
| 1891359576 | Kenneth Ginlack Sr Consulting Services LLC | Counselor | 3927 S Howell Ave Ste 102, Milwaukee, WI 53207-4421 | 2019-04-27 |
| 1649733189 | Stacey King | Counselor | Rivershore Comprehensive Treatment Facility, 3703 N Richards St, Milwaukee Wi, Milwaukee, WI 53212 | 2019-04-11 |
| 1821561168 | Lydia Ann Mendez | Counselor | 3703 N Richards St, Milwaukee, WI 53212 | 2019-01-09 |
| 1851863302 | Glen Victor Fleming | Counselor | 2821 North 4th Street Suite 210, Milwaukee, WI 53212 | 2018-12-21 |
| 1992280218 | Tanya Lynn Peters | Counselor | 9224 W Burleigh St, Milwaukee, WI 53222-3503 | 2018-10-02 |
| 1467948844 | Alexcis Coleman | Counselor | 6815 W Capitol Dr Ste 217, Milwaukee, WI 53216 | 2018-07-09 |
| Find all providers in MILWAUKEE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.