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General NPI Number Information
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NPI Number | 1528941143
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Entity Type | Individual
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Provider Name | JAY YOUMANS CARPENTER
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Gender | Male
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 315 W COURT ST
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City | MILWAUKEE
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State | WI
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Zip | 53212-3844
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Country | US
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Telephone | 414-271-2656
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Fax |
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Provider Business Mailing Address
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Address Line | 8014 N LAKE DR
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City | MILWAUKEE
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State | WI
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Zip | 53217-2916
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Country | US
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Telephone | 414-426-1914
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8537-226
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License Number State | WI
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