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NPI Code Detail

MEDICARE: MISS CARISA MARIE HOUSTON CSAC, CS-IT

MEDICARE: MISS CARISA MARIE HOUSTON CSAC, CS-IT
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) Counselor15606-132WI
2101YA0400XAddiction (Substance Use Disorder) Counselor15528131WI
3101YA0400XAddiction (Substance Use Disorder) Counselor15446IL

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 : 1376729996
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS CARISA MARIE HOUSTON CSAC, CS-IT
Provider Business Mailing Address
First Line : 8444 N 90TH ST STE 100
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85258-4437
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7600 W CAPITOL DR
Second Line :
City : MILWAUKEE
State : WI
Zip : 53222-2055
Country : US
Telephone Number : 414-905-3100
Fax Number : 414-710-9260
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2008
Last Update Date : 04/21/2026

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Directions to “ MISS CARISA MARIE HOUSTON CSAC, CS-IT” Practice Location

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