Carrie Nitz, SAC-IT

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Green Lake, WI

NPI 1992298863 · NPPES record last updated Jun 14, 2018

Key facts

NPI
1992298863
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
18377-130
Practice address
571 County Road a
Green Lake, WI 54941-8630
Phone
(920) 229-3338
NPI assigned
Jun 14, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
County of Green Lake Past
since Jan 14, 2024
Accepting new patients
County of Green Lake Past
since Mar 29, 2007
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 18377-130 Yes

Addresses

Primary practice location

571 County Road a
Green Lake, WI 54941-8630

Mailing address

N8794 Townline Rd
Van Dyne, WI 54979-9736
Phone (920) 979-8104

Other providers in Green Lake, WI

All providers in Green Lake, WI · Addiction (Substance Use Disorder) Counselor in Wisconsin

Sources for this page

Verify at the official NPI Registry.