MEDICARE: JASWINDER MAAN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	12896-123	WI

General Provider Information

NPI Number	:	1013798305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASWINDER MAAN LCSW

Provider Business Mailing Address
First Line	:	6126 49TH AVE
Second Line	:
City	:	KENOSHA
State	:	WI
Zip	:	53142-1324
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6126 49TH AVE
Second Line	:
City	:	KENOSHA
State	:	WI
Zip	:	53142-1324
Country	:	US
Telephone Number	:	224-538-9376
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2023
Last Update Date	:	04/13/2026

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