Provider Demographics
NPI:1164406948
Name:BAER, BARBARA JOSEPHINE (MA LMFT LPC LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:JOSEPHINE
Last Name:BAER
Suffix:
Gender:F
Credentials:MA LMFT LPC LCSW
Other - Prefix:MISS
Other - First Name:BARBARA
Other - Middle Name:JOSPHINE
Other - Last Name:PETTAVINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5300 S 108TH ST
Mailing Address - Street 2:RECOVERY POINT SC SUITE 12B
Mailing Address - City:HALES CORNERS
Mailing Address - State:WI
Mailing Address - Zip Code:53130-1368
Mailing Address - Country:US
Mailing Address - Phone:414-529-2591
Mailing Address - Fax:414-529-2669
Practice Address - Street 1:5300 S 108TH ST
Practice Address - Street 2:RECOVERY POINT SC SUITE 12B
Practice Address - City:HALES CORNERS
Practice Address - State:WI
Practice Address - Zip Code:53130-1368
Practice Address - Country:US
Practice Address - Phone:414-529-2591
Practice Address - Fax:414-529-2669
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI165125101YP2500X
WI19481231041C0700X
WI6124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist