Provider Demographics
NPI:1467588590
Name:MIZER, BARBARA B (MSW,LCSW,CSAC)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:B
Last Name:MIZER
Suffix:
Gender:F
Credentials:MSW,LCSW,CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6618 PRIMROSE WAY
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53406-2678
Mailing Address - Country:US
Mailing Address - Phone:262-989-6212
Mailing Address - Fax:262-989-6212
Practice Address - Street 1:6214 WASHINGTON AVE
Practice Address - Street 2:SUITE C10
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53406-3986
Practice Address - Country:US
Practice Address - Phone:262-989-6212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-25
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6718-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical