Provider Demographics
NPI:1265852727
Name:MEISSNER, JEAN (MSE, NCC, LPC-IT)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:MEISSNER
Suffix:
Gender:F
Credentials:MSE, NCC, LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 GREEN ACRES LN
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-3924
Mailing Address - Country:US
Mailing Address - Phone:920-722-4666
Mailing Address - Fax:
Practice Address - Street 1:1021 GREEN ACRES LN
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-3924
Practice Address - Country:US
Practice Address - Phone:920-722-4666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1479-226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health