Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacob J Lichman Jr., CSACIDP/AT

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1306140967

Jacob J Lichman Jr., CSACIDP/AT is an Addiction (Substance Use Disorder) Counselor in Montello, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2010.

Licensed in
WI
In the registry since
2010

Practice location Address checks out

N3829 State Road 22
Montello, WI 53949-9049
Phone: (608) 297-2085
Fax: (608) 297-2426
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 1853-132 (WI)

Record details

NPI number1306140967
Entity typeIndividual (Type 1)
GenderMale
Credentials CSACIDP/AT
Sole proprietorNo
NPI enumeratedDecember 22, 2010
Last updated in NPPESDecember 22, 2010

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