Individual
HOLLY JORGENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LPC
Contact information
Practice address
401 WISCONSIN AVE, SUITE 100, MADISON, WI 53703-1487
(608) 256-5115
(608) 256-5116
Mailing address
401 WISCONSIN AVE., 401 WISCONSIN AVE., MADISON, WI 53703-1465
(608) 256-5115
(608) 256-5116
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2069-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40909400
—
WI
Enumeration date
10/18/2006
Last updated
02/27/2017
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