Provider Demographics
NPI:1699549337
Name:SALGADO, JESSI EDITH (ATR-P, LPC-IT)
Entity type:Individual
Prefix:
First Name:JESSI
Middle Name:EDITH
Last Name:SALGADO
Suffix:
Gender:F
Credentials:ATR-P, LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 NEWVILLE ST
Mailing Address - Street 2:
Mailing Address - City:EDGERTON
Mailing Address - State:WI
Mailing Address - Zip Code:53534-1915
Mailing Address - Country:US
Mailing Address - Phone:608-501-9808
Mailing Address - Fax:
Practice Address - Street 1:301 S BEDFORD ST STE 7
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-3691
Practice Address - Country:US
Practice Address - Phone:608-501-9808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI23-290221700000X
WI7523226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist