Provider Demographics
NPI:1255059010
Name:BINTZ, PAIGE (LCSW)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:BINTZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2628 N HUMBOLDT BLVD APT 204
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-3067
Mailing Address - Country:US
Mailing Address - Phone:414-722-1372
Mailing Address - Fax:
Practice Address - Street 1:1432 W FOREST HOME AVE STE 400
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53204-3228
Practice Address - Country:US
Practice Address - Phone:414-567-5400
Practice Address - Fax:414-567-5359
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI132843-121104100000X
WI12002-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker