Jessica Marie Pankratz
Addiction Counselor (Substance Use Disorder)
122 E Olin Ave Ste 275
Madison
, Wisconsin 53713-1475
Jessica Marie Pankratz
Addiction Counselor (Substance Use Disorder)
122 E Olin Ave Ste 275
Madison
, Wisconsin 53713-1475
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About
Features
Specialties
- Addiction Counselor (Substance Use Disorder)
Languages spoken
- English
Location
First Address
- Jessica Marie Pankratz
- 7974 Uw Health Ct
- Middleton, WI
- Zip : 53562-5531
- Phone :
Second Address
- Jessica Marie Pankratz
- 122 E Olin Ave Ste 275
- Madison, WI
- Zip : 53713-1475
- Fax : (608) 263-9045
- Phone : (608) 262-1111
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Is Jessica Marie Pankratz a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 15584-132 | WI |
| Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 7533-123 | WI |
National Provider Identifier
| NPI | 1003052572 |
|---|---|
| Provider Name | Jessica Marie Pankratz |
| First Address | Middleton, WI 53562-5531 |
| Second Address | Madison, WI 53713-1475 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/01/2009 |
| Last Update Date | 28/09/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.