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NPI Code Detail

MEDICARE: BARBARA L JOHNSON-GIESE MSW LCSW CSAC ICS

MEDICARE: BARBARA L JOHNSON-GIESE MSW LCSW CSAC ICS
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
1101YA0400XAddiction (Substance Use Disorder) Counselor2031WI
21041C0700XClinical Social Worker

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111997-134OTHERWIINTERMEDIATE CLINICAL SUPERVISOR
22031-132OTHERWICLINICAL SUBSTANCE ABUSE COUNSELOR

General Provider Information

NPI Number : 1861469793
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA L JOHNSON-GIESE MSW LCSW CSAC ICS
Provider Business Mailing Address
First Line : 323 S 18TH AVE
Second Line :
City : STURGEON BAY
State : WI
Zip : 54235-1401
Country : US
Telephone Number : 920-746-3714
Fax Number : 920-746-0099
Provider Business Practice Location Address
First Line : 323 S 18TH AVE
Second Line :
City : STURGEON BAY
State : WI
Zip : 54235-1401
Country : US
Telephone Number : 920-746-3714
Fax Number : 920-746-0099
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2006
Last Update Date : 07/24/2024

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