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NPI Code Detail

MEDICARE: MS. JENNIFER JO LAUBENSTEIN CSAC

MEDICARE:  MS. JENNIFER JO LAUBENSTEIN  CSAC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor15911-132WI

General Provider Information

NPI Number : 1366720286
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER JO LAUBENSTEIN CSAC
Provider Business Mailing Address
First Line : 4472 COUNTY ROAD Y
Second Line :
City : SAUKVILLE
State : WI
Zip : 53080-1236
Country : US
Telephone Number : 262-416-6543
Fax Number :
Provider Business Practice Location Address
First Line : 23 W SCOTT ST
Second Line :
City : FOND DU LAC
State : WI
Zip : 54935-2342
Country : US
Telephone Number : 920-926-0101
Fax Number : 920-926-0060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2011
Last Update Date : 09/27/2016

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Directions to “ MS. JENNIFER JO LAUBENSTEIN CSAC” Practice Location

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