Jennifer Bleak (NPI# 1013124239, PAC ID# 0648410662) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHIATRY.
| Nation Provider ID (NPI) | 1013124239 |
| PAC ID by PECOS | 0648410662 |
| Professional Enrollment ID | I20130715000611 |
| Full Name | Jennifer Bleak |
| Organization Legal Name | SHOREHAVEN BEHAVIORAL HEALTH INC |
| Address |
3900 W Brown Deer Rd Suite 200 Brown Deer WI 53209-1220 |
| Phone Number | 4145402170 |
| Gender | F |
| Medical School | UNIVERSITY OF ILLINOIS AT CHICAGO HEALTH SCIENCE CENTER |
| Graduation Year | 1989 |
| Primary Specialty | PSYCHIATRY |
| Group Practice PAC ID | 0143324954 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520100 | BELOIT HEALTH SYSTEM |
| 520071 | FORT MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 | 6083642200 | BELOIT HEALTH SYSTEM INC |
| 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 | 4145402170 | SHOREHAVEN BEHAVIORAL HEALTH INC |
| 500 Mcmillen St, Fort Atkinson, WI 53538-1233 | 9205635571 | FORT HEALTHCARE INC |
| 512 Wilcox St, Fort Atkinson, WI 53538-1254 | 9205637366 | FORT HEALTHCARE INC |
| 512 Wilcox St Su, Suite 1, Fort Atkinson, WI 53538-1254 | 9205637366 | FORT HEALTHCARE INC |
| 611 E Sherman Ave, Fort Atkinson, WI 53538-1960 | 9205685000 | FORT HEALTHCARE INC |
| 611 Sherman Ave E, Fort Atkinson, WI 53538-1960 | FORT HEALTHCARE INC |
| Organization Legal Name | SHOREHAVEN BEHAVIORAL HEALTH INC |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James A Jensen | Psychologist, Clinical | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Jessica A Weyer | Clinical Social Worker | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Katie Hodgson | Clinical Social Worker | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Terri Kading Wheeler | Clinical Social Worker | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Todd Thomas | Clinical Social Worker | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Clare Ann Lewis | Clinical Social Worker | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Rosalie Cowdin | Clinical Social Worker | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Eliese C Rucktenwald | Clinical Social Worker | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Chelsea R Gilbertson | Clinical Social Worker | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Amber Ellis | Physician Assistant | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Street Address |
3900 W BROWN DEER RD SUITE 200 |
| City | BROWN DEER |
| State | WI |
| Zip | 53209-1220 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James A Jensen | Psychologist, Clinical | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Jessica A Weyer | Clinical Social Worker | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Ratidzai Rioga | Pediatric Medicine | 3900 W Brown Deer Rd, Suite 140, Brown Deer, WI 53209-1220 | |
| Katie Hodgson | Clinical Social Worker | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Terri Kading Wheeler | Clinical Social Worker | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Todd Thomas | Clinical Social Worker | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Clare Ann Lewis | Clinical Social Worker | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Rosalie Cowdin | Clinical Social Worker | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Eliese C Rucktenwald | Clinical Social Worker | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Chelsea R Gilbertson | Clinical Social Worker | Shorehaven Behavioral Health Inc | 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209-1220 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Patricia E Noonan | Clinical Nurse Specialist | Columbia St. Mary's Hospital Milwaukee, Inc | 9233 N Green Bay Rd, Brown Deer, WI 53209-1103 |
| Galina Bakman | Nurse Practitioner | Columbia St. Mary's Hospital Milwaukee, Inc | 9233 N Green Bay Rd, Brown Deer, WI 53209-1103 |
| Yuliy M Pershman | Physical Medicine and Rehabilitation | Ascension Medical Group Southeast Wisconsin Inc | 9252 N Green Bay Rd, Brown Deer, WI 53209-1104 |
| Barry K Gimbel | Cardiovascular Disease (cardiology) | Ascension Medical Group Southeast Wisconsin Inc | 9252 N Green Bay Rd, Milwaukee, WI 53209-1104 |
| Sean P Ronayne | Family Medicine | Ascension Medical Group Southeast Wisconsin Inc | 9252 N Green Bay Rd, Milwaukee, WI 53209-1104 |
| Marina L Kropp | Physical Medicine and Rehabilitation | Ascension Medical Group Southeast Wisconsin Inc | 9252 N Green Bay Rd, Milwaukee, WI 53209-1104 |
| Kelly A Richards | Nurse Practitioner | Ascension Medical Group Southeast Wisconsin Inc | 9252 N Green Bay Rd, Milwaukee, WI 53209-1104 |
| Robert Michael Kitsis | Family Medicine | Columbia St. Mary's Hospital Milwaukee, Inc | 9252 N Green Bay Rd, Fl 2, Brown Deer, WI 53209-1104 |
| Heather M Wells-holtey | Dermatology | Columbia St. Mary's Hospital Milwaukee, Inc | 9252 N Green Bay Rd, Fl 2, Brown Deer, WI 53209-1104 |
| Shannon S Muderlak | Family Medicine | Ascension Medical Group Southeast Wisconsin Inc | 9252 N Green Bay Rd, Milwaukee, WI 53209-1104 |
| Find all physicians in zip 53209 | |||
| City | BROWN DEER |
| Zip Code | 53209 |
| Specialty | PSYCHIATRY |
| City + Specialty | BROWN DEER + PSYCHIATRY |
Please comment or provide details below to improve the information on Jennifer Bleak.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.