Individual
MS. JENNIE MC CANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
128 E OLIN AVE STE 100, MADISON, WI 53713-1467
(608) 252-1320
(608) 252-1333
Mailing address
128 E OLIN AVE STE 100, MADISON, WI 53713-1467
(608) 252-1320
(608) 252-1333
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2919
WI
101YP2500X
Professional Counselor
Primary
2919
WI
104100000X
Social Worker
2919
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2919
WI LICENSE
WI
05
—
39737900
—
WI
Enumeration date
05/18/2007
Last updated
11/20/2024
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