Provider Demographics
NPI:1194008557
Name:BATSON, MARY E (LPC, CSAC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:BATSON
Suffix:
Gender:F
Credentials:LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 BITTERSWEET PL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-2549
Mailing Address - Country:US
Mailing Address - Phone:608-669-5857
Mailing Address - Fax:
Practice Address - Street 1:6602 GRAND TETON PLZ
Practice Address - Street 2:SUITE 190-C
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1091
Practice Address - Country:US
Practice Address - Phone:608-669-5857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5947101YP2500X
WI15988101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)