Individual
MS. BARBARA STITT MISTELE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
655 ROCKLAND RD, SUITE 103, LAKE BLUFF, IL 60044-1782
(847) 986-3717
Mailing address
655 ROCKLAND RD, SUITE 103, LAKE BLUFF, IL 60044-1782
(847) 986-3717
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149001406
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04907177
BLUE CROSS PROVIDER NMBR
IL
Enumeration date
11/15/2006
Last updated
07/08/2007
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