MEDICARE: JUDY ELIZABETH MISER LCSW

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	101YM0800X	Mental Health Counselor	70310	CA
2	1041C0700X	Clinical Social Worker	108769	CA
3	101YP2500X	Professional Counselor	108769	CA

General Provider Information

NPI Number	:	1558896308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY ELIZABETH MISER LCSW

Provider Business Mailing Address
First Line	:	6911 E ATCHISON ST
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93727-1176
Country	:	US
Telephone Number	:	559-519-2165
Fax Number	:

Provider Business Practice Location Address
First Line	:	142 E CALIFORNIA AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93706-3642
Country	:	US
Telephone Number	:	559-519-2165
Fax Number	:

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

Provider Enumeration Date	:	04/28/2017
Last Update Date	:	05/28/2026

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