Provider Demographics
NPI:1134885361
Name:BARANIAK, ANGELA JANELL (CSW)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:JANELL
Last Name:BARANIAK
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 365
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:WI
Mailing Address - Zip Code:54155-0365
Mailing Address - Country:US
Mailing Address - Phone:920-490-3790
Mailing Address - Fax:
Practice Address - Street 1:2640 W POINT RD
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-1344
Practice Address - Country:US
Practice Address - Phone:920-490-3790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12419-120104100000X
WI16133-132101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker