Basic Information
Provider Information | |||||||||
NPI: | 1194850982 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | GEIGER | ||||||||
FirstName: | JOANN | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | LPC, SAC-IT | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | JUNEAU COUNTY DEPT OF HUMAN SERVICES | ||||||||
Address2: | 200 HICKORY ST | ||||||||
City: | MAUSTON | ||||||||
State: | WI | ||||||||
PostalCode: | 53948 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6088472400 | ||||||||
FaxNumber: | 6088479421 | ||||||||
Practice Location | |||||||||
Address1: | JUNEAU COUNTY DEPT OF HUMAN SERVICES | ||||||||
Address2: | 200 HICKORY ST | ||||||||
City: | MAUSTON | ||||||||
State: | WI | ||||||||
PostalCode: | 53948 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6088472400 | ||||||||
FaxNumber: | 6088479421 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 02/22/2007 | ||||||||
LastUpdateDate: | 09/22/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 09/22/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 18627-130 | WI | N |   | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YP2500X | 3604-125 | WI | Y |   | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
ID | Type | State | Issuer | Description | 43704000 | 05 | WI |   | MEDICAID |