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General NPI Number Information
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NPI Number | 1265896138
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Entity Type | Individual
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Provider Name | JENNIFER KLEKAMP SAC, LPC
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Gender | Female
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Dates
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Enumeration Date | 04/07/2016
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 2010 EASTWOOD DR STE 102
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City | MADISON
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State | WI
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Zip | 53704-5387
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Country | US
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Telephone | 608-291-3676
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Fax | 608-716-3156
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Provider Business Mailing Address
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Address Line | 2010 EASTWOOD DR STE 104
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City | MADISON
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State | WI
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Zip | 53704-5387
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Country | US
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Telephone | 608-291-3676
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Fax | 608-716-3156
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 16150-131
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 7532-125
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License Number State | WI
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