| Jacob J Lichman Jr, CSAC IDP/AT | |
|
N3829 State Road 22, Montello, WI 53949-9049 | |
| (608) 297-2085 | |
| (608) 297-2426 |
| Full Name | Jacob J Lichman Jr |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | N3829 State Road 22, Montello, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306140967 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1853-132 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob J Lichman Jr, CSAC IDP/AT Po Box 57, Montello, WI 53949-0057 Ph: (608) 297-2085 | Jacob J Lichman Jr, CSAC IDP/AT N3829 State Road 22, Montello, WI 53949-9049 Ph: (608) 297-2085 |
Tiffany Schmit, CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 480 Underwood Ave, Montello, WI 53949 Phone: 608-297-3181 Fax: 608-297-2148 | |
James A Webb, CSAC, ICS Counselor Medicare: Not Enrolled in Medicare Practice Location: 480 Underwood Ave, Montello, WI 53949 Phone: 608-297-3181 Fax: 608-297-2148 | |
Lisa Dedrick, Counselor Medicare: Not Enrolled in Medicare Practice Location: 480 Underwood Ave, Montello, WI 53949 Phone: 608-297-3181 | |
Clint Starks, SACIT, LPCIT Counselor Medicare: Not Enrolled in Medicare Practice Location: 480 Underwood Ave, Montello, WI 53949 Phone: 608-297-3181 Fax: 608-297-2148 | |
Stacy L. Webb, RN, CSAC, ICS Counselor Medicare: Not Enrolled in Medicare Practice Location: 480 Underwood Ave, Montello, WI 53949 Phone: 608-297-3181 Fax: 608-297-2148 |