Provider Demographics
NPI:1043352388
Name:MANCHESTER ALLEMEIER, JANA
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:MANCHESTER ALLEMEIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANA
Other - Middle Name:
Other - Last Name:MANCHESTER-ALLEMEIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:301 S BEDFORD ST STE 4A
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-4020
Mailing Address - Country:US
Mailing Address - Phone:608-283-9291
Mailing Address - Fax:608-237-2587
Practice Address - Street 1:301 S BEDFORD ST STE 4A
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-4020
Practice Address - Country:US
Practice Address - Phone:608-283-9291
Practice Address - Fax:608-237-2587
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00995101YM0800X
WI4376-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI4376-125OtherSTATE OF WISCONSIN LICENSE NUMBER
47294OtherNATIONAL CERTIFIED COUNSELOR #
11827683OtherCAQH