MEDICARE: LISA BARNABY

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	10282125	WI
2	101YM0800X	Mental Health Counselor
3	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1376138313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA BARNABY

Provider Business Mailing Address
First Line	:	1958 CEDAR CIR
Second Line	:
City	:	STURGEON BAY
State	:	WI
Zip	:	54235-8372
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	217 N 4TH AVE FL 2
Second Line	:
City	:	STURGEON BAY
State	:	WI
Zip	:	54235-2405
Country	:	US
Telephone Number	:	920-495-0903
Fax Number	:

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

Provider Enumeration Date	:	03/02/2021
Last Update Date	:	03/30/2026

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Directions to “ LISA BARNABY ” Practice Location

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