MEDICARE: JANET MIZZI BALSER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	0701008828	VA

General Provider Information

NPI Number	:	1114566882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET MIZZI BALSER LPC

Provider Business Mailing Address
First Line	:	816 ENTRY SCHOOL RD
Second Line	:
City	:	WAYNESBORO
State	:	VA
Zip	:	22980-6576
Country	:	US
Telephone Number	:	540-290-4427
Fax Number	:

Provider Business Practice Location Address
First Line	:	843 SPRING HILL RD
Second Line	:
City	:	STAUNTON
State	:	VA
Zip	:	24401-2866
Country	:	US
Telephone Number	:	540-290-4427
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2019
Last Update Date	:	12/30/2019

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