Healthcare Provider Details

I. General information

NPI: 1982949210
Provider Name (Legal Business Name): JESSICA E DINGEE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA E SCHELLING MSW

II. Dates (important events)

Enumeration Date: 11/27/2012
Last Update Date: 04/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 E OLIN AVE SUITE 100
MADISON WI
53713-1467
US

IV. Provider business mailing address

202 S PARK ST
MADISON WI
53715-1596
US

V. Phone/Fax

Practice location:
  • Phone: 608-316-1186
  • Fax: 608-252-1333
Mailing address:
  • Phone: 608-417-3886
  • Fax: 608-417-3886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: