| Jessica Young, LPC, CMHIMP | |
|
129 Kenosha St, Walworth, WI 53184 | |
| (262) 607-2770 | |
| Not Available |
| Full Name | Jessica Young |
|---|---|
| Gender | Female |
| Speciality | Mental Health Counselor |
| Experience | 17 Years |
| Location | 129 Kenosha St, Walworth, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902200108 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 5479-125 (Wisconsin) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Center For Change, Llc | 9830534551 | 2 |
| Entity Name | Center For Change, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720511330 PECOS PAC ID: 9830534551 Enrollment ID: O20240304001640 |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Young, LPC, CMHIMP Po Box 252, Walworth, WI 53184 Ph: (262) 607-2770 | Jessica Young, LPC, CMHIMP 129 Kenosha St, Walworth, WI 53184 Ph: (262) 607-2770 |
Samantha Golembiewski, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 124 Phillips Ave, Walworth, WI 53184 Phone: 815-671-1681 | |
Krysta Zarnstorff, Counselor Medicare: Not Enrolled in Medicare Practice Location: 129 Kenosha St, Walworth, WI 53184 Phone: 262-607-2770 | |
Isabelle Wangerin, Counselor Medicare: Accepting Medicare Assignments Practice Location: 129 Kenosha St, Walworth, WI 53184 Phone: 262-607-2770 | |
Mr. Daniel William Rankin, Counselor Medicare: Not Enrolled in Medicare Practice Location: 129 Kenosha St, Walworth, WI 53184 Phone: 262-607-2770 |