Provider Demographics
NPI:1265896138
Name:KLEKAMP, JENNIFER (SAC, LPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:KLEKAMP
Suffix:
Gender:F
Credentials:SAC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 EASTWOOD DR STE 104
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-5387
Mailing Address - Country:US
Mailing Address - Phone:608-291-3676
Mailing Address - Fax:608-716-3156
Practice Address - Street 1:2010 EASTWOOD DR STE 102
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-5387
Practice Address - Country:US
Practice Address - Phone:608-291-3676
Practice Address - Fax:608-716-3156
Is Sole Proprietor?:No
Enumeration Date:2016-04-07
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16150-131101YA0400X
WI7532-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)