Individual
JACKIE S LEGLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, SAC
Contact information
Practice address
903 MINERAL POINT AVE, JANESVILLE, WI 53548-2970
(608) 756-5555
(608) 756-0174
Mailing address
903 MINERAL POINT AVE, JANESVILLE, WI 53548-2970
(608) 756-5555
(608) 756-0174
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
16929-130
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
16050-131
WI
101YP2500X
Professional Counselor
Primary
4727-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851795728
—
WI
01
—
LEGLEJAC
MERCYCARE INSURANCE
WI
Enumeration date
10/21/2014
Last updated
07/21/2022
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