Provider Demographics
NPI:1497739486
Name:LEMANSKI, JEAN R (LPC, CSAC, ICS)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:R
Last Name:LEMANSKI
Suffix:
Gender:F
Credentials:LPC, CSAC, ICS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 WEST SEVENTH ST.
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911
Mailing Address - Country:US
Mailing Address - Phone:920-739-3981
Mailing Address - Fax:920-731-2853
Practice Address - Street 1:607 WEST SEVENTH ST.
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911
Practice Address - Country:US
Practice Address - Phone:920-739-3981
Practice Address - Fax:920-731-2853
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12117101YA0400X
WI31078101YM0800X
WI605-1211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39721200Medicaid
WI55941OtherSECURITY INS