| Gjb Health Services, Llc | |
|
2323 W Everett St Appleton WI 54914-4749 | |
| (920) 560-4585 | |
| (920) 560-6618 |
| Full Name | Gjb Health Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2323 W Everett St, Appleton, Wisconsin |
| Authorized Official Name and Position | Gloria Jean Bannasch (OWNER ACCESS MANAGER) |
| Authorized Official Contact | 9202177861 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gjb Health Services, Llc 2323 W Everett St Appleton WI 54914-4749 Ph: (920) 560-4525 | Gjb Health Services, Llc 2323 W Everett St Appleton WI 54914-4749 Ph: (920) 560-4585 |
| NPI Number | 1659711687 |
|---|---|
| Provider Enumeration Date | 07/05/2013 |
| Last Update Date | 01/07/2025 |
| Certification Date | 01/07/2025 |
| Medicare PECOS PAC ID | 5496068405 |
|---|---|
| Medicare Enrollment ID | O20150721000083 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659711687 | NPI | - | NPPES |
| 100077381 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Benjamin R Cheney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477727097 PECOS PAC ID: 9739316928 Enrollment ID: I20131213001224 |
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