SARA N JETTAWI LPC NPI 1447912480

NPI Information

NPI: 1447912480
Provider Name: SARA N JETTAWI, LPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

PECOS Registration: Yes

Address:
2108 63RD ST
KENOSHA, WI
ZIP 53143
Phone: (262) 652-2406
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Sara N Jettawi, LPC is a professional counselor in Kenosha, WI. Sara N Jettawi, LPC NPI is 1447912480. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2108 63RD ST
KENOSHA, WI
ZIP 53143-454
Phone: (262) 652-2406

The NPI 1447912480 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 10/7/2021 and was last updated on 1/23/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	104100000X	Social Worker		5035-226	WISCONSIN	No
2	101YP2500X	Counselor	Professional	10456-125	WISCONSIN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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