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Individual

JACLYN A HEBERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, CSAC

Contact information

Practice address
903 MINERAL POINT AVE, JANESVILLE, WI 53548-2970
(608) 756-5555
(608) 756-0174
Mailing address
903 MINERAL POINT AVE, JANESVILLE, WI 53548-2970
(608) 756-5555
(608) 756-0174

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
14731-130
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
15416-132
WI
101YP2500X
Professional Counselor
Primary
4440-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1306093539
WI
05
42028500
WI
01
HEBERJAC
MERCYCARE INSURANCE
WI
Enumeration date
08/19/2008
Last updated
03/16/2016
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