LISA MARIE PORTMANN (NPI# 1114255361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114255361 |
| Entity Type | Individual |
| Full Name | LISA MARIE PORTMANN |
| Credential | BSW, TCSW, SAC-IT |
| Practice Address |
3301 N Ballard Rd Ste B Appleton WI 54911-9002 |
| Practice Telephone | 9207334443 |
| Practice Fax Number | 9207334796 |
| Mailing Telephone | 9207334443 |
| Mailing Fax Number | 9207334796 |
| Enumeration Date | 2009-11-30 |
| Last Update Date | 2009-11-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
15863-130 | WI | Behavioral Health & Social Service Providers |
| N | 104100000X | Social Worker | 10300-120 | WI | Behavioral Health & Social Service Providers |
| Street Address |
3301 N BALLARD RD STE B |
| City | APPLETON |
| State | WI |
| Zip Code | 54911-9002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881808533 | Jacob Edward Struhelka | Counselor | 3301 N Ballard Rd Ste B, Appleton, WI 54911-9002 | 2007-05-10 |
| 1811596315 | Sue Srnka | Counselor | 3301 N Ballard Rd Ste B, Appleton, WI 54911-9002 | 2020-10-26 |
| 1841812294 | David Bushey | Counselor | 3301 N Ballard Rd Ste B, Appleton, WI 54911-9002 | 2020-05-08 |
| 1710509161 | Elizabeth Talcott | Counselor | 3301 N Ballard Rd Ste B, Appleton, WI 54911-9002 | 2020-05-08 |
| 1831725621 | Mary L Reynolds | Registered Nurse | 3301 N Ballard Rd Ste B, Appleton, WI 54911-9002 | 2020-03-12 |
| 1255965349 | Barbara Denise Johnson | Registered Nurse | 3301 N Ballard Rd Ste B, Appleton, WI 54911-9002 | 2020-02-27 |
| 1003449596 | Vicki Lynn Aho | Registered Nurse | 3301 N Ballard Rd Ste B, Appleton, WI 54911-9002 | 2020-02-13 |
| 1700419231 | Melissa R Stuczynski | Licensed Vocational Nurse | 3301 N Ballard Rd Ste B, Appleton, WI 54911-9002 | 2020-02-12 |
| 1255810115 | Jennifer Lynn Tennessen | Counselor | 3301 N Ballard Rd Ste B, Appleton, WI 54911-9002 | 2018-08-11 |
| 1609368984 | Laurie Kurth | Counselor | 3301 N Ballard Rd Ste B, Appleton, WI 54911-9002 | 2018-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912545633 | Brotherly Love, LLC | Day Training, Developmentally Disabled Services | 1513 E Frances St, Appleton, WI 54911 | 2019-12-12 |
| 1952952129 | Eagle Point Senior Living Inc | Assisted Living Facility | 995 East John Street, Appleton, WI 54911 | 2019-09-27 |
| 1619524766 | University Rx LLC | Pharmacy | 133 E College Ave, Appleton, WI 54911 | 2019-08-23 |
| 1174080063 | Shayla Russell | Counselor | Outagamie County Health and Human Services, 320 S. Walnut St., Appleton, WI 54911 | 2019-02-27 |
| 1871086645 | Megan Kilsdonk | Health Educator | 1604 N Meade St, Appleton, WI 54911 | 2018-06-07 |
| 1871085480 | Tanya Lynn Vickery | Social Worker | 410 S. Elm St., Appleton, WI 54911 | 2018-05-31 |
| 1013407501 | Teri G Metropulos | Counselor | 229 S. Morrison, Appleton, WI 54911 | 2018-05-10 |
| 1093211211 | Bonnie Anne Korytkowski | Student in an Organized Health Care Education/Training Program | 229 S. Morrison Street, Appleton, WI 54911 | 2018-04-05 |
| 1639673940 | Brett Follett | Psychologist | 401 S. Elm St., Appleton, WI 54911 | 2018-03-21 |
| 1700202892 | Brian Withrow | Counselor | 607 West 7th St., Appleton, WI 54911 | 2014-03-13 |
| Find all providers in zip 54911 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295373843 | Life Counseling & Consulting, LLC | Counselor | 101 W Edison Avenue, Suite 117, Appleton, WI 54915-1930 | 2019-12-13 |
| 1699233270 | A Village LLC | Counselor | 2031 E Calumet St, Appleton, WI 54915-4742 | 2019-03-04 |
| 1578081766 | Erin Bozich | Counselor | 1000 N Lynndale Dr Ste C, Appleton, WI 54914-3057 | 2017-09-07 |
| 1124542709 | Anthony Edward Klingert | Counselor | 3003 N Richmond St # A, Appleton, WI 54911-1148 | 2017-07-26 |
| 1043661036 | Wisconsin Lutheran Child & Family Service | Counselor | 5300 N Meade St, Appleton, WI 54913-8383 | 2016-06-30 |
| 1700202892 | Brian Withrow | Counselor | 607 West 7th St., Appleton, WI 54911 | 2014-03-13 |
| 1356766406 | Renee Taylor | Counselor | 201 S Glenridge Ct, Appleton, WI 54914-3905 | 2014-02-26 |
| 1720351729 | James Edward Reider | Counselor | 3301 3301 N. Ballard Road, Appleton, WI 54911-9002 | 2012-02-22 |
| 1477845147 | Mallory Barbara Herrin | Counselor | 820 W. College Ave, Appleton, WI 54914 | 2011-05-12 |
| 1982933479 | Stephanie I. Braski | Counselor | 1531 S. Oneida St, Appleton, WI 54915 | 2009-12-14 |
| Find all providers in APPLETON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.