JENNY M BOMBER (NPI# 1407377633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407377633 |
| Entity Type | Individual |
| Full Name | JENNY M BOMBER |
| Credential | MA, LPC |
| Practice Address |
626 S Irwin Ave Green Bay WI 54301-3304 |
| Mailing Address |
Po Box 22308 Green Bay WI 54305-2308 |
| Practice Telephone | 9204333372 |
| Practice Fax Number | 9204333383 |
| Mailing Telephone | 9204366800 |
| Mailing Fax Number | 9204325966 |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2017-06-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
6489 | WI | Behavioral Health & Social Service Providers |
| Street Address |
626 S IRWIN AVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-3304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194842880 | Family Services of Northeast Wisconsin | Case Management | 626 S Irwin Ave, Green Bay, WI 54301-3304 | 2007-03-26 |
| 1790301414 | Jodi Ann Strebel-dahl | Counselor | 626 S Irwin Ave, Green Bay, WI 54301-3304 | 2020-06-18 |
| 1346861556 | Kristin C Kouba | Social Worker | 626 S Irwin Ave, Green Bay, WI 54301-3304 | 2020-04-28 |
| 1083273627 | Brooke Daverveld | Social Worker | 626 S Irwin Ave, Green Bay, WI 54301-3304 | 2019-06-07 |
| 1457818429 | Lydia Jones | Counselor | 626 S Irwin Ave, Green Bay, WI 54301-3304 | 2019-02-26 |
| 1053881607 | Paige M Dorn | Social Worker | 626 S Irwin Ave, Green Bay, WI 54301 | 2018-11-27 |
| 1821568437 | John R Cheslock | Counselor | 626 S Irwin Ave, Green Bay, WI 54301-3304 | 2018-11-27 |
| 1942721105 | Jennifer J Marolt | Counselor | 626 S Irwin Ave, Green Bay, WI 54301-3304 | 2017-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760099329 | Spencer Rea Hansen Thomas | Counselor | 3340 Lineville Rd, Green Bay, WI 54313-7237 | 2020-09-28 |
| 1952914780 | Michelle Lee Barth | Counselor | 208 Longview Ave, Green Bay, WI 54301-1034 | 2020-08-31 |
| 1811412521 | Karlye Krien | Counselor | 1061 W Mason St, Green Bay, WI 54303-1858 | 2017-08-03 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1205387271 | Anne Karjala-dobbins | Counselor | 1985 E Telemark Cir, Green Bay, WI 54313-4335 | 2016-10-14 |
| 1689026650 | Catherine Calo | Counselor | 529 Greene Ave, Green Bay, WI 54301-2819 | 2016-07-01 |
| 1225498983 | Michael Sherman Fentress | Counselor | 2711 Humboldt Rd Apt 2, Green Bay, WI 54311-8463 | 2016-02-24 |
| 1831566363 | Stephanie Birmingham | Counselor | 1900 Morrow St, #106, Green Bay, WI 54302-3479 | 2015-09-01 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1700272929 | Kerri Schmidt | Counselor | 916 Willard Drive, Suite #136, Green Bay, WI 54304-6223 | 2015-04-14 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.