Individual provider · Type 1 NPI

Sandra Jacques, LCSW

Clinical Social Worker · Port Washington, WI

NPI number 1154312544 Active

Practice location

121 W Main St, Suite 350
Port Washington, WI 53074-1813

Call (262) 284-8130 Map

Fax (262) 284-8104

Mailing address

PO Box 994, Suite 350
Port Washington, WI 53074-0994

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X548123 (WI)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1154312544

Sandra Jacques, LCSW's National Provider Identifier is 1154312544, issued on Nov 3, 2005. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Port Washington, WI. The record was last updated on Jul 13, 2026.