Provider Demographics
NPI:1356871354
Name:TRZEBIATOWSKI, JILL M (LPC)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:M
Last Name:TRZEBIATOWSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:M
Other - Last Name:SCHEIDEGGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:111 W JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:WISCONSIN RAPIDS
Mailing Address - State:WI
Mailing Address - Zip Code:54495-2702
Mailing Address - Country:US
Mailing Address - Phone:715-421-8845
Mailing Address - Fax:715-421-2266
Practice Address - Street 1:111 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:WISC RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54495-2702
Practice Address - Country:US
Practice Address - Phone:715-421-8845
Practice Address - Fax:715-421-2266
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-13
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2356-226261QM0801X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty