Provider Demographics
NPI:1841228491
Name:KEMNITZER, JANE E (LCSW)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:E
Last Name:KEMNITZER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W ALONA LN
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:WI
Mailing Address - Zip Code:53813-2202
Mailing Address - Country:US
Mailing Address - Phone:608-723-6357
Mailing Address - Fax:608-723-4417
Practice Address - Street 1:200 W ALONA LN
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:WI
Practice Address - Zip Code:53813-2202
Practice Address - Country:US
Practice Address - Phone:608-723-6357
Practice Address - Fax:608-723-4417
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2599-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI396623475003OtherBLUE CROSS/BLUE SHIELD
WI40953500Medicaid
WI40953500OtherHIRSP
WI40953500Medicaid