Provider Demographics
NPI:1033501366
Name:PLEUSS, MARY JO (CSW, ICS, CSAC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:JO
Last Name:PLEUSS
Suffix:
Gender:F
Credentials:CSW, ICS, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:BEAVER DAM
Mailing Address - State:WI
Mailing Address - Zip Code:53916-2119
Mailing Address - Country:US
Mailing Address - Phone:920-887-1766
Mailing Address - Fax:920-887-2322
Practice Address - Street 1:115 N CENTER ST
Practice Address - Street 2:
Practice Address - City:BEAVER DAM
Practice Address - State:WI
Practice Address - Zip Code:53916-2119
Practice Address - Country:US
Practice Address - Phone:920-887-1766
Practice Address - Fax:920-887-2322
Is Sole Proprietor?:No
Enumeration Date:2015-02-24
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15337-135101YA0400X
WI15380-132101YA0400X
WI2687-120104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)