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

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1043303787

Jacqueline Lee Landers, MSWLCSWCSAC is a Clinical Social Worker in Elm Grove, Wisconsin. Qualified in 1997, 29 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
29
Licensed in
WI
In the registry since
2006
Specialties on file
2
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Practice location Address checks out

700 Pilgrim Pkwy Ste 203
Elm Grove, WI 53122-2064
Phone: (262) 408-0588
Fax: (262) 599-8119
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 6864-123 (WI)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 11947 (WI)

Record details

NPI number1043303787
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSWLCSWCSAC
Sole proprietorYes
NPI enumeratedOctober 2, 2006
Last updated in NPPESAugust 21, 2025
Certification dateAugust 21, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Elm Grove