Provider Demographics
NPI:1841228491
Name:KEMNITZER, JANE E (LCSW)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:E
Last Name:KEMNITZER
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:PO BOX 7
Mailing Address - Street 2:
Mailing Address - City:REWEY
Mailing Address - State:WI
Mailing Address - Zip Code:53580-0007
Mailing Address - Country:US
Mailing Address - Phone:608-574-4352
Mailing Address - Fax:
Practice Address - Street 1:101 STONIER LN
Practice Address - Street 2:
Practice Address - City:RIDGEWAY
Practice Address - State:WI
Practice Address - Zip Code:53582-9798
Practice Address - Country:US
Practice Address - Phone:608-341-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2025-03-13
Deactivation Date:2025-02-04
Deactivation Code:
Reactivation Date:2025-03-13
Provider Licenses
StateLicense IDTaxonomies
WI2599-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI396623475003OtherBLUE CROSS/BLUE SHIELD
WI40953500Medicaid
WI40953500OtherHIRSP
WI40953500Medicaid