Provider Demographics
NPI:1780731430
Name:HERINK, JENNIFER KRAEMER (MS LPC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:KRAEMER
Last Name:HERINK
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1173 108TH AVE
Mailing Address - Street 2:
Mailing Address - City:ROBERTS
Mailing Address - State:WI
Mailing Address - Zip Code:54023-8539
Mailing Address - Country:US
Mailing Address - Phone:715-749-4457
Mailing Address - Fax:
Practice Address - Street 1:715 ORANGE ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-1763
Practice Address - Country:US
Practice Address - Phone:715-386-1634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3303-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional