Healthcare Provider Details

I. General information

NPI: 1598951832
Provider Name (Legal Business Name): JENNIFER R ALWARD MA MFT AT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 E WALL ST
EAGLE RIVER WI
54521
US

IV. Provider business mailing address

1791 HELEN LAKE RD
EAGLE RIVER WI
54521-8521
US

V. Phone/Fax

Practice location:
  • Phone: 715-255-0311
  • Fax:
Mailing address:
  • Phone: 715-781-7350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4768-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: