Von Der Linden, Jayne E

Von Der Linden, Jayne E is an individual health care provider with primary practice located at 300 Crooks St , Green Bay WI 54301-4527. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Von Der Linden, Jayne E can be contacted via phone (920) 436-6800.

Contact Information

Primary practice address
300 Crooks St Green Bay WI 54301-4527
Fax: (920) 432-5966
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 4289123 Wisconsin

Profile Details

NPI number 1003871740
LBN Legal business name Von Der Linden, Jayne E
Credentials MSW
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Apr 22nd, 2009 - about 15 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 1003871740 NPPES
Wisconsin MEDICAID 43559200
Wisconsin Other P00214690

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