Healthcare Provider Details

I. General information

NPI: 1912838095
Provider Name (Legal Business Name): MS. JENNIFER MARIE JANVIERE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

6001 W CENTER ST STE 105
MILWAUKEE WI
53210-2154
US

IV. Provider business mailing address

118 N 70TH ST
MILWAUKEE WI
53213-3832
US

V. Phone/Fax

Practice location:
  • Phone: 414-930-3244
  • Fax:
Mailing address:
  • Phone: 414-460-7259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: