MEDICARE: BARBARA STUTZ 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	1041C0700X	Clinical Social Worker	2485-123	WI

General Provider Information

NPI Number	:	1598706004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA STUTZ LCSW

Provider Business Mailing Address
First Line	:	4421 N MURRAY AVE
Second Line	:
City	:	SHOREWOOD
State	:	WI
Zip	:	53211-1644
Country	:	US
Telephone Number	:	414-964-0985
Fax Number	:

Provider Business Practice Location Address
First Line	:	930 E KNAPP ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-2800
Country	:	US
Telephone Number	:	414-221-0022
Fax Number	:

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	07/08/2007

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Directions to “ BARBARA STUTZ LCSW” Practice Location

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