Provider Demographics
NPI:1801458658
Name:OPPENEER, JEANI M (LPC)
Entity type:Individual
Prefix:
First Name:JEANI
Middle Name:M
Last Name:OPPENEER
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 1:118 N MADISON ST
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:WI
Mailing Address - Zip Code:53589-1530
Mailing Address - Country:US
Mailing Address - Phone:608-235-9625
Mailing Address - Fax:
Practice Address - Street 1:118 N MADISON ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:WI
Practice Address - Zip Code:53589-1530
Practice Address - Country:US
Practice Address - Phone:608-235-9625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3162-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI3162-226OtherWISCONSIN DEPT. OF SAFETY AND PROFESSIONAL SERVICES