Provider Demographics
NPI:1053464511
Name:WARNER, JENNIFER M (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:WARNER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 W WASHINGTON AVE
Mailing Address - Street 2:SUITE 308
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-4704
Mailing Address - Country:US
Mailing Address - Phone:608-251-6590
Mailing Address - Fax:608-251-6591
Practice Address - Street 1:660 W WASHINGTON AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-4704
Practice Address - Country:US
Practice Address - Phone:608-251-6590
Practice Address - Fax:608-251-6591
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3477106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist