Provider Demographics
NPI:1316393226
Name:PRITZL, HEIDI ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:ANN
Last Name:PRITZL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:HEIDI
Other - Middle Name:ANN
Other - Last Name:KARNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:240 MAPLE ST.
Mailing Address - Street 2:
Mailing Address - City:WOODRUFF
Mailing Address - State:WI
Mailing Address - Zip Code:54568
Mailing Address - Country:US
Mailing Address - Phone:715-356-8740
Mailing Address - Fax:
Practice Address - Street 1:240 MAPLE ST.
Practice Address - Street 2:
Practice Address - City:WOODRUFF
Practice Address - State:WI
Practice Address - Zip Code:54568
Practice Address - Country:US
Practice Address - Phone:715-356-8740
Practice Address - Fax:715-356-8525
Is Sole Proprietor?:No
Enumeration Date:2016-05-10
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8109-1231041C0700X
WI8109-123LCSW104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIIN PROCESS OF ENROLLMedicaid