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

Jennifer Gullo

Individual provider Clinical Social Worker · NPI 1164887774

Jennifer Gullo is a Clinical Social Worker in Racine, Wisconsin. Qualified in 2013, 13 years ago. Practices with Ascension Medical Group-Southeast Wisconsin Inc, a 555-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
13
Licensed in
WI
In the registry since
2015
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Practice location Address checks out

1320 Wisconsin Ave
Racine, WI 53403-1978
Phone: (262) 687-2380
Fax: (262) 687-2495
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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 8402 (WI)

Record details

NPI number1164887774
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 24, 2015
Last updated in NPPESDecember 24, 2015
Mailing address1320 Wisconsin Ave, Racine, WI 53403-1978

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Ascension Medical Group-Southeast Wisconsin Inc — 555 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Racine