Individual ProviderJo Anne PedersenSocial WorkerBehavioral Health & Social Service ProvidersPractice Address5000 W National Ave, Milwaukee, WI 53295-0001(414) 384-2000(262) 352-6047PECOS EnrollmentBased on the most recent information from CMS, provider Jo Anne Pedersen does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:47 AM.Profile DetailsProvider ID1023183134Provider TypeIndividualFull NamePedersen, Jo AnneTitleMs.CredentialMSWGenderFemaleSole ProprietorNoEnumeration Date11/22/2006Last Updated10/25/2007Contact InformationPractice LocationPractice Address5000 W National Ave, Milwaukee, WI 53295-0001Phone(414) 384-2000FaxUnlisted FaxMailing LocationMailing Address201 Circle Dr, Hartland, WI 53029-1806Phone(262) 352-6047FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense6849123WisconsinCode101YA0400XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense13938WisconsinProvider IdentifiersIDDescriptionIssuerID43572000DescriptionMedicaidIssuerUnlistedWisconsin