Provider Demographics
NPI:1750860375
Name:LAURENZI, JESSIE (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:JESSIE
Middle Name:
Last Name:LAURENZI
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 MONROE ST STE 4
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-2470
Mailing Address - Country:US
Mailing Address - Phone:608-218-4034
Mailing Address - Fax:
Practice Address - Street 1:1920 MONROE ST STE 4
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2470
Practice Address - Country:US
Practice Address - Phone:608-218-4034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2024-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10590-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional