Carrasco, Jennifer M

Carrasco, Jennifer M is an individual health care provider with primary practice located at 2555 N Dr Martin Luther King Dr , Milwaukee WI 53212-2709. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Carrasco, Jennifer M can be contacted via phone (414) 372-8080.

Contact Information

Primary practice address
2555 N Dr Martin Luther King Dr Milwaukee WI 53212-2709
Phone: (414) 372-8080
Fax: (414) 267-8570
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 3124-57 Wisconsin
Behavioral Health & Social Service Providers / Psychologist 103T00000X 3124-57 Wisconsin

Profile Details

NPI number 1528353422
LBN Legal business name Carrasco, Jennifer M
Credentials M.A. PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2011
Last updated Jul 3rd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528353422 NPPES
Wisconsin MEDICAID 100015903

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