MRS. CARRIE JEAN BANASZAK (NPI# 1144600149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144600149 |
| Entity Type | Individual |
| Full Name | MRS. CARRIE JEAN BANASZAK |
| Credential | LPC |
| Practice Address |
1039 Mason Street Green Bay WI 54303 |
| Mailing Address |
N88w14983 Cleveland Ave 3 Menomonee Falls WI 53051 |
| Practice Telephone | 2625101152 |
| Mailing Telephone | 2625101152 |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2018-04-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
2259-226 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100055240 | 05 |
| Street Address |
1039 MASON STREET |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| 1063730042 | Bradley C Heraly | Internal Medicine | 1726 Shawano Avenue, Green Bay Oncology, Green Bay, WI 54303 | 2010-05-14 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760099329 | Spencer Rea Hansen Thomas | Counselor | 3340 Lineville Rd, Green Bay, WI 54313-7237 | 2020-09-28 |
| 1952914780 | Michelle Lee Barth | Counselor | 208 Longview Ave, Green Bay, WI 54301-1034 | 2020-08-31 |
| 1811412521 | Karlye Krien | Counselor | 1061 W Mason St, Green Bay, WI 54303-1858 | 2017-08-03 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1205387271 | Anne Karjala-dobbins | Counselor | 1985 E Telemark Cir, Green Bay, WI 54313-4335 | 2016-10-14 |
| 1689026650 | Catherine Calo | Counselor | 529 Greene Ave, Green Bay, WI 54301-2819 | 2016-07-01 |
| 1225498983 | Michael Sherman Fentress | Counselor | 2711 Humboldt Rd Apt 2, Green Bay, WI 54311-8463 | 2016-02-24 |
| 1831566363 | Stephanie Birmingham | Counselor | 1900 Morrow St, #106, Green Bay, WI 54302-3479 | 2015-09-01 |
| 1700272929 | Kerri Schmidt | Counselor | 916 Willard Drive, Suite #136, Green Bay, WI 54304-6223 | 2015-04-14 |
| 1316338502 | Marisa Leisten | Counselor | 2881 Saint Anthony Dr, Apartment 16, Green Bay, WI 54311-4828 | 2015-02-10 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.