Provider Demographics
NPI:1407486541
Name:JOCHMAN, GABRIELLE CASSANDRA (LCSW)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:CASSANDRA
Last Name:JOCHMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GABRIELLE
Other - Middle Name:CASSANDRA SAMSON
Other - Last Name:JOCHMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SW
Mailing Address - Street 1:1900 SILVER LAKE RD NW STE 110
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-1789
Mailing Address - Country:US
Mailing Address - Phone:651-628-9566
Mailing Address - Fax:651-628-0411
Practice Address - Street 1:2500 E ENTERPRISE AVE STE B
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-8556
Practice Address - Country:US
Practice Address - Phone:920-416-8577
Practice Address - Fax:920-416-8581
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9881-1231041C0700X, 1041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical