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NPI Code Detail

MEDICARE: MS. LISA JANINE HAJEK L.M.F.T.

MEDICARE: MS. LISA JANINE HAJEK L.M.F.T.
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
1106H00000XMarriage & Family Therapist724-124WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174535322
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LISA JANINE HAJEK L.M.F.T.
Provider Business Mailing Address
First Line : 1716 FORDEM AVE
Second Line :
City : MADISON
State : WI
Zip : 53704-4604
Country : US
Telephone Number : 608-442-4159
Fax Number :
Provider Business Practice Location Address
First Line : 1716 FORDEM AVE
Second Line :
City : MADISON
State : WI
Zip : 53704-4604
Country : US
Telephone Number : 608-442-4159
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2006
Last Update Date : 11/23/2011

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