Landers, Jacqueline Lee

Landers, Jacqueline Lee is an sole proprietor health care provider with primary practice located at 15460 W Capitol Dr Ste 222 , Brookfield WI 53005-2632. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Landers, Jacqueline Lee can be contacted via phone (262) 408-0588.

Contact Information

Primary practice address
15460 W Capitol Dr Ste 222 Brookfield WI 53005-2632
Phone: (262) 408-0588
Fax: (262) 373-0362
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 11947 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 6864-123 Wisconsin

Profile Details

NPI number 1043303787
LBN Legal business name Landers, Jacqueline Lee
Credentials MSW LCSW CSAC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 2nd, 2006
Last updated May 16th, 2020 - about 4 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 1043303787 NPPES
Wisconsin MEDICAID 40922200

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