Healthcare Provider Details

I. General information

NPI: 1609113232
Provider Name (Legal Business Name): JILL R. TURCOTT-NIELSEN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2013
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 GLEN COVE LN
BROOKFIELD WI
53005-3258
US

IV. Provider business mailing address

2230 GLEN COVE LANE
BROOKFIELD WI
53005
US

V. Phone/Fax

Practice location:
  • Phone: 262-395-4444
  • Fax:
Mailing address:
  • Phone: 262-395-4444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2573-123
License Number StateWI

VIII. Authorized Official

Name: MS. JILL R. TURCOTT-NIELSEN
Title or Position: CLINIC OWNER
Credential: LCSW
Phone: 262-395-4444