MEDICARE: JENNA MCKEEFRY MS, 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
1	101YM0800X	Mental Health Counselor	6600-125	WI
2	101YP2500X	Professional Counselor	6600-125	WI

General Provider Information

NPI Number	:	1942708177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA MCKEEFRY MS, LPC

Provider Business Mailing Address
First Line	:	2119 HEIGHTS DR
Second Line	:
City	:	EAU CLAIRE
State	:	WI
Zip	:	54701-6130
Country	:	US
Telephone Number	:	715-717-5899
Fax Number	:

Provider Business Practice Location Address
First Line	:	2119 HEIGHTS DR
Second Line	:
City	:	EAU CLAIRE
State	:	WI
Zip	:	54701-6130
Country	:	US
Telephone Number	:	715-717-5899
Fax Number	:

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

Provider Enumeration Date	:	01/23/2018
Last Update Date	:	09/27/2022

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