Individual
JANE EMILY KLINGBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COUNSELOR
Contact information
Practice address
1620 S LAWE ST STE 1, APPLETON, WI 54915-2419
(920) 284-9676
(920) 481-3121
Mailing address
5756 N YOSEMITE LN, APPLETON, WI 54913-2734
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11161-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11161-125
WISCONSIN INDEPENDENT COUNSELOR LICENSE (LPC)
WI
05
—
1265023352
—
WI
01
—
178000697
ILLINOIS COUNSELOR LICENSE NUMBER
IL
01
—
180015956
STATE OF ILLINOIS INDEPENDENT COUNSELOR LICENSE (LCPC)
IL
Enumeration date
02/01/2021
Last updated
02/25/2025
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