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NPI Code Detail

MEDICARE: GABRIELA JUMP LPC

MEDICARE: GABRIELA JUMP LPC
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) Counselor18679-130WI
2101YP2500XProfessional Counselor4334-226WI

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 : 1821640335
Entity Type Code : Individual
Provider Name (Legal Business Name) : GABRIELA JUMP LPC
Provider Business Mailing Address
First Line : 811 E WASHINGTON AVE STE 400
Second Line :
City : MADISON
State : WI
Zip : 53703-4028
Country : US
Telephone Number : 608-389-0253
Fax Number :
Provider Business Practice Location Address
First Line : 811 E WASHINGTON AVE STE 400
Second Line :
City : MADISON
State : WI
Zip : 53703-4028
Country : US
Telephone Number : 608-389-0253
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2019
Last Update Date : 04/13/2022

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Directions to “ GABRIELA JUMP LPC” Practice Location

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