Provider Demographics
NPI:1073242442
Name:DR. JENNIFER BARENZ, LICENSED PSYCHOLOGIST, LLC
Entity Type:Organization
Organization Name:DR. JENNIFER BARENZ, LICENSED PSYCHOLOGIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BARENZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:920-539-9635
Mailing Address - Street 1:838 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-1826
Mailing Address - Country:US
Mailing Address - Phone:920-539-9635
Mailing Address - Fax:
Practice Address - Street 1:838 HIGH ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1826
Practice Address - Country:US
Practice Address - Phone:920-539-9635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)