Provider Demographics
NPI:1083749766
Name:JURGENSEN, HELEN F (LCSW MSW)
Entity Type:Individual
Prefix:MS
First Name:HELEN
Middle Name:F
Last Name:JURGENSEN
Suffix:
Gender:F
Credentials:LCSW MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 080196
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53208-8003
Mailing Address - Country:US
Mailing Address - Phone:414-476-1073
Mailing Address - Fax:414-476-0223
Practice Address - Street 1:5508 W VLIET ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208-8003
Practice Address - Country:US
Practice Address - Phone:414-476-1073
Practice Address - Fax:414-476-0223
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WILCSW5831231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI280196OtherVALUE OPTIONS