Healthcare Provider Details

I. General information

NPI: 1649751223
Provider Name (Legal Business Name): JENNIFER JANOWITZ MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2018
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 W RANCHITO LN
MEQUON WI
53092-6089
US

IV. Provider business mailing address

1423 W PORTVIEW DR
PORT WASHINGTON WI
53074-2460
US

V. Phone/Fax

Practice location:
  • Phone: 262-241-3231
  • Fax:
Mailing address:
  • Phone: 865-742-5869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8557-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: