Individual
MARK W JUERGENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW LPC
Contact information
Practice address
4330 GOLF TER, SUITE 214, EAU CLAIRE, WI 54701-4683
(715) 833-2121
(715) 833-2131
Mailing address
4330 GOLF TER, SUITE 214, EAU CLAIRE, WI 54701-4683
(715) 833-2121
(715) 833-2131
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1839125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40986200
—
WI
01
—
574
BCBS MN
MN
01
—
6250399
MEDICA UBH UHC
MN
01
—
95846
SECURITY HEALTH PLAN
WI
01
—
HP52029
HEALTH PARTNERS
MN
Enumeration date
04/25/2006
Last updated
05/08/2013
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