| Organization Name: | FAMILY SERVICES OF NORTHEAST WI, INC |
| NPI Number: | 1679769343 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KATHERINE K JENSEN (LICENSED PROFESSIONAL COUNSELOR) |
| Mailing Address: | 3430 Spirit Way Green Bay |
| State: | WI US |
| Postal Code: | 543045687 |
| Phone Number: | 9203300339 |
| Fax Number: | |
| NPI Enumeration Date: | 09/17/2007 |
| NPI Last Update Date: | 09/17/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 3851-125 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |