JENNIFER MARIE HENDRICKSON PC-IT SAC-IT NPI 1689935983

NPI Information

NPI: 1689935983
Provider Name: JENNIFER MARIE HENDRICKSON, PC-IT, SAC-IT
Classification: Counselor - 101YA0400X
Specialization: Addiction (Substance Use Disorder)
Entity Type: Individual
Address: 612 N RANDALL AVE
SUITE A
JANESVILLE, WI
ZIP 53545
Phone: (608) 752-7660

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NPI Details

Jennifer Marie Hendrickson, PC-IT, SAC-IT is an addiction (substance use disorder) counselor in Janesville, WI. Jennifer Marie Hendrickson, PC-IT, SAC-IT NPI is 1689935983. 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:

612 N RANDALL AVE
SUITE A
JANESVILLE, WI
ZIP 53545-958
Phone: (608) 752-7660
Fax: (608) 752-9788

The enumeration date for this NPI number is 6/4/2012 and was last updated on 6/4/2012.

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	101Y00000X	Counselor		1434-226	WISCONSIN	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	16441-130	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1434-226	OTHER	WISCONSIN	DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES
2	16441-130	OTHER	WISCONSIN	DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES

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: 11/21/2025

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