JESSICA L JACH (NPI# 1699143909) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699143909 |
| Entity Type | Individual |
| Full Name | JESSICA L JACH |
| Other Name | JESSICA L PETERSON |
| Credential | LCSW, MSW |
| Practice Address |
2600 Humes Rd Ste 100 Janesville WI 53545-0491 |
| Practice Telephone | 6087412117 |
| Practice Fax Number | 6087585761 |
| Mailing Telephone | 6087412117 |
| Mailing Fax Number | 6087585761 |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2019-12-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | 129191-121 | WI | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
9310-123 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1699143909 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 20 E Court St, Janesville, WI 535453919 | 6087558923 | 6087585761 |
| Street Address |
2600 HUMES RD STE 100 |
| City | JANESVILLE |
| State | WI |
| Zip Code | 53545-0491 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851546667 | Amanda L Ballard | Counselor | 2600 Humes Rd Ste 100, Janesville, WI 53545 | 2008-11-20 |
| 1376178350 | Monica L. Hinkle | Social Worker | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2020-03-10 |
| 1467082313 | Jacquelyn M. O'flahrity | Social Worker | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2020-01-20 |
| 1972163004 | Danielle R. Ebben | Counselor | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2019-06-20 |
| 1518521186 | Debra K. Westby | Social Worker | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2019-04-29 |
| 1881165991 | Sarah A. Wellnitz | Social Worker | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2018-12-16 |
| 1568986578 | Deborah A. Dubanowich | Counselor | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2017-08-01 |
| 1336529932 | Phillip L. Stall | Psychiatry & Neurology | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2015-06-09 |
| 1194043554 | Rathna Sree Mallela | Psychiatry & Neurology | 2600 Humes Rd Ste 100, Janesville, WI 53545-0491 | 2010-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730743816 | Wisteria Lyn Gunnink | Social Worker | 3530 N County Highway F, Janesville, WI 53545 | 2019-04-24 |
| 1730601295 | Selma Mohammedi | Dentist | 1260 Milton Ave Ste 140-150, Janesville, WI 53545 | 2017-07-16 |
| 1205357472 | Andrea Jayne Thompson | Physical Therapist | 3418 N Parker Dr., Janesville, WI 53545 | 2017-06-28 |
| 1639549983 | Sylvia Andrus | Physical Therapy Assistant | 3400 N Country Highway F, Janesville, WI 53545 | 2015-09-30 |
| 1518372564 | Kimberly Ann Bishop | Registered Nurse | 32 E. Racine Street, Suite 150, Janesville, WI 53545 | 2014-06-29 |
| 1679998314 | Quirt Family Dentistry | Dentist | 2201 Humes Road Suite 150, Janesville, WI 53545 | 2014-03-04 |
| 1104163740 | Sarah J Fredricks | Licensed Practical Nurse | 1406 Holiday Drive, Janesville, WI 53545 | 2013-01-15 |
| 1659629335 | Parvin Mesbah | Pharmacist | 2017 Old Humes Road, T-0809, Janesville, WI 53545 | 2012-08-28 |
| 1962797118 | Tiffany Schmidt | Pharmacist | 2017 Humes Road, T-0809, Janesv Ille, WI 53545 | 2011-06-16 |
| 1174817795 | Megan Steiner | Dentist | 1504 Creston Park Drive, Janesville, WI 53545 | 2011-05-31 |
| Find all providers in zip 53545 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730743816 | Wisteria Lyn Gunnink | Social Worker | 3530 N County Highway F, Janesville, WI 53545 | 2019-04-24 |
| 1275043697 | Amy Albert | Social Worker | 1611 Center Ave, Janesville, WI 53546-2819 | 2017-10-11 |
| 1144415696 | Stacy L Farrington | Social Worker | 3530 N County Rd E # F, Janesville, WI 53548-9074 | 2007-09-07 |
| 1710195136 | Stephen P Daly | Social Worker | 2020 E Milwaukee, 9, Janesville, WI 53545 | 2007-05-18 |
| 1265579304 | Tracy A. Mayer | Social Worker | 3530 N. County Trunk Highway F, Janesville, WI 53547-1649 | 2007-01-30 |
| 1457373870 | Kathy Ann Fox | Social Worker | 2020 E Milwaukee St, Janesville, WI 53545-2600 | 2006-07-24 |
| 1871526269 | Leanne Furman | Social Worker | 1519 Primrose Ln, Janesville, WI 53545-0418 | 2006-07-08 |
| 1407897242 | Neil B Gragg, Jr. | Social Worker | 519 Midland Ct, Suite #102, Janesville, WI 53546-2336 | 2006-06-10 |
| 1891346169 | Sarah K Birdsill | Social Worker | 23 N Main St, Janesville, WI 53545-3039 | 2019-09-26 |
| 1972077527 | Lotus Counseling, LLC | Social Worker | 23 N Main St, Janesville, WI 53545-3039 | 2019-01-16 |
| Find all providers in JANESVILLE | ||||
| City | JANESVILLE |
| Zip Code | 53545 |
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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.