Provider Demographics
NPI:1942715370
Name:RECKNER, JENNIFER (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:RECKNER
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 1:437 S YELLOWSTONE DR STE 219
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1061
Mailing Address - Country:US
Mailing Address - Phone:608-200-2332
Mailing Address - Fax:608-535-6874
Practice Address - Street 1:437 S YELLOWSTONE DR STE 219
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1061
Practice Address - Country:US
Practice Address - Phone:608-200-2332
Practice Address - Fax:608-535-6874
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7861-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional