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General NPI Number Information
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NPI Number | 1033501366
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Entity Type | Individual
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Provider Name | MARY JO PLEUSS CSW, ICS, CSAC
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Gender | Female
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Dates
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Enumeration Date | 02/24/2015
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 115 N CENTER ST
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City | BEAVER DAM
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State | WI
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Zip | 53916-2119
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Country | US
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Telephone | 920-887-1766
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Fax | 920-887-2322
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Provider Business Mailing Address
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Address Line | 115 N CENTER ST
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City | BEAVER DAM
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State | WI
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Zip | 53916-2119
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Country | US
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Telephone | 920-887-1766
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Fax | 920-887-2322
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 15337-135
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 15380-132
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 2687-120
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License Number State | WI
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