HALEY JACOB (NPI# 1659819076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659819076 |
| Entity Type | Individual |
| Full Name | HALEY JACOB |
| Practice Address |
1725 State St 126 Mitchell Hall La Crosse WI 54601-3742 |
| Mailing Address |
18442 High Pkwy Rocky River OH 44116-2829 |
| Practice Telephone | 2169781173 |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2017-02-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 405300000X | Prevention Professional | 1901-39 | WI | Other Service Providers |
| Street Address |
1725 STATE ST 126 MITCHELL HALL |
| City | LA CROSSE |
| State | WI |
| Zip Code | 54601-3742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477527596 | Cordial M. Gillette | Specialist/Technologist | 1725 State St, 151 Mitchell Hall, La Crosse, WI 54601-3742 | 2006-02-15 |
| 1316575061 | Matthew Richard Zamzow | Physician Assistant | 1725 State St, La Crosse, WI 54601-3742 | 2020-03-30 |
| 1902434483 | Drew Ebert | Student in an Organized Health Care Education/Training Program | 1725 State St, 4051 Health Science Center, La Crosse, WI 54601 | 2020-03-30 |
| 1780212779 | Emma Louise Messerich | Student in an Organized Health Care Education/Training Program | 1725 State St, La Crosse, WI 54601-3742 | 2020-03-27 |
| 1114555166 | Christina Erdmann | Student in an Organized Health Care Education/Training Program | 1725 State St, La Crosse, WI 54601-3742 | 2020-03-27 |
| 1942838883 | Katherine Pranica | Student in an Organized Health Care Education/Training Program | 1725 State St, La Crosse, WI 54601-3742 | 2020-03-27 |
| 1124656103 | Bailey Bogatitus | Student in an Organized Health Care Education/Training Program | 1725 State St, La Crosse, WI 54601-3742 | 2020-03-27 |
| 1093343055 | Bridget Alyssa Burke | Student in an Organized Health Care Education/Training Program | 1725 State St, La Crosse, WI 54601-3742 | 2020-03-27 |
| 1215565205 | Alison Seemann | Student in an Organized Health Care Education/Training Program | 1725 State St, La Crosse, WI 54601-3742 | 2020-03-27 |
| 1083242036 | Erica Lynn Beine | Student in an Organized Health Care Education/Training Program | 1725 State St, La Crosse, WI 54601-3742 | 2020-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324265 | Meagan Mcrae | Student in an Organized Health Care Education/Training Program | 1725 State St., 4051 Health Science Center, La Crosse, WI 54601 | 2020-04-07 |
| 1255969671 | Erin Dingman | Student in an Organized Health Care Education/Training Program | 1751 State Street, 4051 Health Science Center, La Crosse, WI 54601 | 2020-03-31 |
| 1619505047 | Nicole Kay Lynch | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State St, La Crosse, WI 54601 | 2020-03-31 |
| 1174151757 | Jenna Sells | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1740818301 | Katie Irene Tahtinen | Student in an Organized Health Care Education/Training Program | Uwl- 4051 Health Science Center, 1725 State St., La Crosse, WI 54601 | 2020-03-30 |
| 1932737517 | Margaret May Grimm | Student in an Organized Health Care Education/Training Program | Univesity of Wisconsin-la Crosse, 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1831727312 | Matthew Timothy Axler | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1093340473 | Denise Stinson | Technician | 1311 Badger St, Apt 505, La Crosse, WI 54601 | 2020-03-06 |
| 1922632397 | Ibrahim Ahsan | Pharmacist | 1105 Wi-16, La Crosse, WI 54601 | 2020-02-25 |
| 1750913356 | Liza R Collins | Massage Therapist | 1415 State Wi 16, La Crosse, WI 54601 | 2020-02-11 |
| Find all providers in zip 54601 | ||||
| Taxonomy Code | 405300000X |
| Grouping | Other Service Providers |
| Classification | Prevention Professional |
| Prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326679663 | Andrea Maria Dosedla | Prevention Professional | N61w23044 Harrys Way, Sussex, WI 53089-3995 | 2020-01-27 |
| 1063981710 | Jon Maurice Smoots | Prevention Professional | 7710 W. Casper Street, Milwaukee, WI 53216 | 2018-11-23 |
| 1023527769 | Red Road House | Prevention Professional | 152 S Locust St, Janesville, WI 53548-3767 | 2017-09-26 |
| 1164963187 | Anna Lanman | Prevention Professional | 303 12th Ave, Baraboo, WI 53913-1612 | 2017-03-09 |
| 1407396013 | Douglas Radtke | Prevention Professional | 6233 Bankers Rd, Suite 12, Mount Pleasant, WI 53403-9700 | 2017-03-01 |
| 1043627912 | Sonia Porter | Prevention Professional | 5151 W Silver Spring Dr, Milwaukee, WI 53218-3300 | 2014-07-12 |
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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.