Provider Demographics
NPI:1174650857
Name:OSINSKI, JESSICA ANN (LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:OSINSKI
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 1:2600 N MAYFAIR RD STE 305
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1303
Mailing Address - Country:US
Mailing Address - Phone:414-257-0233
Mailing Address - Fax:414-257-3588
Practice Address - Street 1:2600 N MAYFAIR RD STE 305
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-1303
Practice Address - Country:US
Practice Address - Phone:414-257-0233
Practice Address - Fax:414-257-3588
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3722-125101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43598700Medicaid