Jendusa, John Peter
Jendusa, John Peter is an individual health care provider with primary practice located at 5225 North Ironwood Road 102, Glendale WI 53217. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Jendusa, John Peter can be contacted via phone (414) 962-9156.Contact Information
Primary practice address
5225 North Ironwood Road 102
Glendale WI 53217
Phone: (414) 962-9156
Fax: (414) 962-4356
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2251-123 | Wisconsin |
Profile Details
| NPI number | 1770691164 |
|---|---|
| LBN Legal business name | Jendusa, John Peter |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 27th, 2006 |
| Last updated | Aug 26th, 2008 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770691164 | NPPES |
| Wisconsin | MEDICAID | 39237400 |
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