NPI 1588980403 · live from the CMS NPI Registry
Jackilyn Andrew, LCSW
Social Worker, Clinical in Eau Claire, WI. National Provider Identifier 1588980403, active.
NPI record
| NPI | 1588980403 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 1400 Bellinger St, Eau Claire, WI 54703 |
| Practice phone | 715-838-5222 |
| Mailing address | 200 1st St Sw, Rochester, MN 55905 |
| Enumerated | April 16, 2010 |
| Last updated | August 11, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical | 1041C0700X | 34005989 (IN) |
| Social Worker, Clinical primary | 1041C0700X | 7664 (WI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.