Individual
LISA T BARGENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CSAC
Contact information
Practice address
505 BROADWAY ST, BARABOO, WI 53913-2183
(608) 355-4200
(608) 355-4299
Mailing address
2514 LENNON ST, PORTAGE, WI 53901-1125
(608) 843-4800
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
18096
WI
104100000X
Social Worker
130020-121
WI
1041C0700X
Clinical Social Worker
Primary
8967
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100058771
—
WI
Enumeration date
07/28/2016
Last updated
02/01/2022
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