Provider Demographics
NPI:1952764706
Name:LOUTHER, JEANNE (LPC, SAC)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:LOUTHER
Suffix:
Gender:F
Credentials:LPC, SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W11211 COUNTY ROAD G
Mailing Address - Street 2:
Mailing Address - City:BEAVER DAM
Mailing Address - State:WI
Mailing Address - Zip Code:53916-9567
Mailing Address - Country:US
Mailing Address - Phone:608-206-0186
Mailing Address - Fax:
Practice Address - Street 1:199 COUNTY ROAD DF FL 3
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:WI
Practice Address - Zip Code:53039-9512
Practice Address - Country:US
Practice Address - Phone:920-386-4094
Practice Address - Fax:920-386-4564
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health