Tabbert, Jerald F

Tabbert, Jerald F is an individual health care provider with primary practice located at 123 16Th Ave S , Onalaska WI 54650-3109. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Tabbert, Jerald F can be contacted via phone (608) 775-8646.

Contact Information

Primary practice address
123 16Th Ave S Onalaska WI 54650-3109
Phone: (608) 775-8646
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 7590-123 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 16091-130 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 7590 Wisconsin

Profile Details

NPI number 1497807796
LBN Legal business name Tabbert, Jerald F
Credentials Master of Science in Social Work (MSSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2007
Last updated Apr 22nd, 2014 - about 10 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 1497807796 NPPES
Wisconsin MEDICAID 40906100

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