Provider Demographics
NPI:1134800170
Name:BAAS, JEANETTE JOSEPH (LCSW)
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:JOSEPH
Last Name:BAAS
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 1:122 GREEN BAY RD STE 3
Mailing Address - Street 2:
Mailing Address - City:THIENSVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53092-1679
Mailing Address - Country:US
Mailing Address - Phone:414-306-8655
Mailing Address - Fax:
Practice Address - Street 1:122 GREEN BAY RD STE 3
Practice Address - Street 2:
Practice Address - City:THIENSVILLE
Practice Address - State:WI
Practice Address - Zip Code:53092-1679
Practice Address - Country:US
Practice Address - Phone:414-306-8655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11070-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical