Individual
JENNIFER MICHENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, SAC
Contact information
Practice address
2422 N GRANDVIEW BLVD, WAUKESHA, WI 53188-6105
(262) 549-6600
Mailing address
2422 N GRANDVIEW BLVD, WAUKESHA, WI 53188-6105
(262) 549-6600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16007-131
WI
101YM0800X
Mental Health Counselor
6076-125
WI
Other
Enumeration date
04/23/2014
Last updated
05/25/2016
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