Provider Demographics
NPI:1881462828
Name:JASKOLSKI, CZARINA E (LPC)
Entity type:Individual
Prefix:
First Name:CZARINA
Middle Name:E
Last Name:JASKOLSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 WILLIAMSTOWNE STE 101
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-2332
Mailing Address - Country:US
Mailing Address - Phone:262-337-9770
Mailing Address - Fax:262-337-9771
Practice Address - Street 1:383 WILLIAMSTOWNE STE 101
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-2332
Practice Address - Country:US
Practice Address - Phone:262-337-9770
Practice Address - Fax:262-337-9771
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11312-125101YM0800X
WI7394-226101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health