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Individual

MARY C GIRSH-JENSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW CSAC

Contact information

Practice address
3601 30TH AVE, SUITE 102, KENOSHA, WI 53144-1695
(262) 654-0487
(262) 654-2434
Mailing address
3601 30TH AVE, SUITE 102, KENOSHA, WI 53144-1695
(262) 654-0487
(262) 654-2434

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11266-132
WI
1041C0700X
Clinical Social Worker
Primary
7062-123
WI

Other

Enumeration date
12/12/2014
Last updated
12/12/2014
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