Provider Demographics
NPI:1861469793
Name:JOHNSON-GIESE, BARBARA L (MSW LCSW CSAC ICS)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:L
Last Name:JOHNSON-GIESE
Suffix:
Gender:F
Credentials:MSW LCSW CSAC ICS
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:L
Other - Last Name:VISTE-JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:323 S 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:STURGEON BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54235-1401
Mailing Address - Country:US
Mailing Address - Phone:920-746-3714
Mailing Address - Fax:920-746-0099
Practice Address - Street 1:323 S 18TH AVE
Practice Address - Street 2:
Practice Address - City:STURGEON BAY
Practice Address - State:WI
Practice Address - Zip Code:54235-1401
Practice Address - Country:US
Practice Address - Phone:920-746-3714
Practice Address - Fax:920-746-0099
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2031101YA0400X
WI6759123104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI2031-132OtherCLINICAL SUBSTANCE ABUSE COUNSELOR
WI11997-134OtherINTERMEDIATE CLINICAL SUPERVISOR
WI393493000Medicaid
WI393493000Medicaid