person
Jacob J Lichman JR., CSACIDP/AT
Addiction (Substance Use Disorder) Counselor in Montello, Wisconsin
NPI 1306140967

Jacob J Lichman JR. is an Addiction (Substance Use Disorder) Counselor based in Montello, WI and is specialized in Addiction (Substance Use Disorder). Jacob J Lichman JR. practices in Montello, WI and has the professional credentials of CSACIDP/AT. The NPI Number for Jacob J Lichman JR. is 1306140967 and holds a License No. 1853-132 (Wisconsin).

The current practice location address for Jacob J Lichman JR. is N3829 State Road 22, Montello, WI and can be reached out via phone at 608-297-2085 and via fax at 608-297-2426.

Location: N3829 State Road 22, Montello, WI, 53949-0057
person
Provider Profile Details
NPI Number
1306140967
Provider Name
Jacob J Lichman JR.
Credential
CSACIDP/AT
Provider Entity Type
Individual
Gender
Male
Address
N3829 State Road 22, Montello, WI, 53949-0057
Phone Number
608-297-2085
Fax Number
608-297-2426
Provider Enumeration Date
12/22/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
N3829 State Road 22
City
State
Zip
53949-9049
Phone Number
608-297-2085
Fax Number
608-297-2426
person
Provider Business Mailing Address Details
Address
N3829 State Road 22
City
State
Zip
53949-9049
Phone Number
608-297-2085
Fax Number
608-297-2426
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
1853-132 (Wisconsin)
Definition
Definition to come...
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