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NPI Code Detail

MEDICARE: MRS. CARRIE JEAN BANASZAK LPC

MEDICARE: MRS. CARRIE JEAN BANASZAK 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
1101YP2500XProfessional Counselor6867-125WI
2101YP2500XProfessional Counselor2259-226WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144600149
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARRIE JEAN BANASZAK LPC
Provider Business Mailing Address
First Line : 4800 N SCOTTSDALE RD STE 2500
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-7630
Country : US
Telephone Number : 262-999-3495
Fax Number :
Provider Business Practice Location Address
First Line : 9809 S FRANKLIN DR STE 302
Second Line :
City : FRANKLIN
State : WI
Zip : 53132-8885
Country : US
Telephone Number : 262-999-3495
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2015
Last Update Date : 10/03/2025

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Directions to “ MRS. CARRIE JEAN BANASZAK LPC” Practice Location

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