MS. Jacquelyn Mae Block, MFT, LCSW, LMFT
MS. Jacquelyn Mae Block, MFT, LCSW, LMFT is a Clinical Social Worker in Fond Du Lac, Wisconsin. Qualified in 1990, 36 years ago. Practices with Agnesian Healthcare Inc, a 390-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.
- Years since qualifying
- 36
- Licensed in
- WI
- In the registry since
- 2007
- Specialties on file
- 2
What do these letters mean?
- MFT — Marriage and Family Therapist
- A therapist who treats couples and families.
- LCSW — Licensed Clinical Social Worker
- A social worker licensed to diagnose and treat mental health conditions independently.
- LMFT — Licensed Marriage and Family Therapist
- A therapist licensed to treat couples and families.
Practice location Address checks out
430 E Division StFond Du Lac, WI 54935-4560
Phone: (920) 926-4209
Show map & directions
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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 2841-123 (WI) |
|---|---|
| Marriage & Family Therapist | Taxonomy 106H00000X · Licence 226-124 (WI) |
Record details
| NPI number | 1336360429 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | MFT , LCSW , LMFT |
| Sole proprietor | No |
| NPI enumerated | May 2, 2007 |
| Last updated in NPPES | December 16, 2020 |
| Certification date | December 16, 2020 |
Medicare enrollment
| Medicare specialty | CLINICAL SOCIAL WORKER |
|---|---|
| Medical school | OTHER |
| Graduated | 1990 (36 years in practice) |
| Group practice | Agnesian Healthcare Inc — 390 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Telehealth | Offers telehealth services |
Other providers in Fond Du Lac
-
Mrs. Ruth Alicia Sobeck, MS, LMFT
757 S Main St Ste 8, Fond Du Lac, WI 54935-5708 · (800) 438-1772
-
MS. Sharon Ann Teschke, LCSW, LMFT
196 3rd St, Fond Du Lac, WI 54935-4418 · (920) 921-3343