Provider Demographics
NPI:1316824873
Name:BLAESER, ALYSSA ANN (LCSW)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:ANN
Last Name:BLAESER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1726 REMPE DR
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-1254
Mailing Address - Country:US
Mailing Address - Phone:715-828-1253
Mailing Address - Fax:715-828-1253
Practice Address - Street 1:1726 REMPE DR
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-1254
Practice Address - Country:US
Practice Address - Phone:715-828-1253
Practice Address - Fax:715-828-1253
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12516-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical