| Brandy N Jastrow, LCSW | |
|
Po Box 396, Crandon, WI 54520-0396 | |
| (715) 478-4339 | |
| (715) 478-4494 |
| Full Name | Brandy N Jastrow |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | Po Box 396, Crandon, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124521414 | NPI | - | NPPES |
| 130878-121 | Other | WI | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801108974 (Michigan) | Secondary |
| 1041C0700X | Social Worker - Clinical | 9535-123 (Wisconsin) | Primary |
| Entity Name | Forest County Potawatomi Community |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285741306 PECOS PAC ID: 3375454689 Enrollment ID: O20040228000204 |
| Mailing Address | Practice Location Address |
|---|---|
| Brandy N Jastrow, LCSW 1635 Maple Ln, Ashland, WI 54806-3610 Ph: (715) 685-5400 | Brandy N Jastrow, LCSW Po Box 396, Crandon, WI 54520-0396 Ph: (715) 478-4339 |
Mrs. Gloria Jean Johnston, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5409 Everybodys Road, Forest County Potawatomi Health & Wellness Center, Crandon, WI 54520 Phone: 715-478-4300 Fax: 715-478-4490 | |
Abigail B Ashbeck, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 3144 Vanzile Rd, Crandon, WI 54520 Phone: 715-478-5180 | |
Dr. Stephanie Marie Coons, DSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3144 Vanzile Rd, Crandon, WI 54520 Phone: 715-478-5180 | |
Amy E Booher, APSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 8201 Mish Ko Swen Dr, Crandon, WI 54520 Phone: 715-478-4339 | |
Tracy Lynne Ferraro-schumacher, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 400 W Glen St, Crandon, WI 54520 Phone: 715-478-6300 |