Provider Demographics
NPI:1851461099
Name:KREEB, JENNIFER BETH (LPC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:BETH
Last Name:KREEB
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W333S7940 FORSETH DR
Mailing Address - Street 2:
Mailing Address - City:MUKWONAGO
Mailing Address - State:WI
Mailing Address - Zip Code:53149-9377
Mailing Address - Country:US
Mailing Address - Phone:414-217-6330
Mailing Address - Fax:
Practice Address - Street 1:W333S7940 FORSETH DR
Practice Address - Street 2:
Practice Address - City:MUKWONAGO
Practice Address - State:WI
Practice Address - Zip Code:53149-9377
Practice Address - Country:US
Practice Address - Phone:414-217-6330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4563-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional