Organization
TAYLOR COUNTY
Active
Other names
Taylor County Human Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAREN SUE JACOBSON CADC III, IDP-AT (CERTIFIED SUBSTANCE ABUSE COUNSELOR)
(715) 748-3332
Entity
Organization
Contact information
Practice address
540 COLLEGE AVE, MEDFORD, WI 54451-2027
(715) 748-3332
(715) 748-3342
Mailing address
540 COLLEGE AVE, MEDFORD, WI 54451-2027
(715) 748-3332
(715) 748-3342
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11414
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11414
STATE LICENSE NUMBER
WI
05
—
39385400
—
WI
01
—
72970
SECURITY HEALTH PLAN INS
WI
Enumeration date
05/10/2007
Last updated
12/19/2007
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