Ms Jacquelyn Mae Block, MFT, LCSW, LMFT is a medicare enrolled "Social Worker - Clinical" provider in Fond Du Lac, Wisconsin. Her current practice location is
430 E Division St, Fond Du Lac, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 926-4209.
Ms Jacquelyn Mae Block is licensed to practice in Wisconsin (license number 2841-123) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1336360429.
Healthcare Provider's Profile
| Full Name | Ms Jacquelyn Mae Block |
|---|
| Gender | Female |
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| Speciality | |
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| Experience | Years |
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| Location | 430 E Division St, Fond Du Lac, Wisconsin |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Ms Jacquelyn Mae Block attended and graduated from in
NPI Data:
- NPI Number: 1336360429
- Provider Enumeration Date: 05/02/2007
- Last Update Date: 12/16/2020
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Ms Jacquelyn Mae Block such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1336360429 | NPI | - | NPPES |
| 226-124 | Other | WI | LMFT |
| 2841-123 | Other | WI | LCSW |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 106H00000X | Marriage & Family Therapist | 226-124 (Wisconsin) | Secondary |
| 1041C0700X | Social Worker - Clinical | 2841-123 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Jacquelyn Mae Block is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Jacquelyn Mae Block, MFT, LCSW, LMFT
420 E Division St,
Fond Du Lac, WI 54935-4560
Ph: (920) 926-4209 | Ms Jacquelyn Mae Block, MFT, LCSW, LMFT
430 E Division St,
Fond Du Lac, WI 54935-4560
Ph: (920) 926-4209 |
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