MEDICARE: JACLYN SITKOWSKI

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	101YM0800X	Mental Health Counselor	6784-125	WI

General Provider Information

NPI Number	:	1639529779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACLYN SITKOWSKI

Provider Business Mailing Address
First Line	:	213 E WHITEFISH RD
Second Line	:
City	:	PORT WASHINGTON
State	:	WI
Zip	:	53074-1336
Country	:	US
Telephone Number	:	414-215-0847
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 E WHITEFISH RD
Second Line	:
City	:	PORT WASHINGTON
State	:	WI
Zip	:	53074-1336
Country	:	US
Telephone Number	:	414-215-0847
Fax Number	:

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

Provider Enumeration Date	:	06/20/2016
Last Update Date	:	02/13/2026

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Directions to “ JACLYN SITKOWSKI ” Practice Location

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