MISS MARISA AUSBORN WIZEMAN M.S.
NPI 1104105543
Counselor - Mental Health in Bath, NY
About Miss Marisa Ausborn Wizeman M.s. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MISS MARISA AUSBORN WIZEMAN M.S. (NPI 1104105543) is an individual mental health provider in Bath, New York, licensed in New York (005318) and active in the NPI registry since August 2011. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Miss Marisa Ausborn Wizeman M.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Marisa Wizeman's NPI number?
The NPI number for Marisa Wizeman is 1104105543. It was assigned to this individual provider in the NPPES registry on August 16, 2011.
Where is Marisa Wizeman located?
Marisa Wizeman practices at 115 Liberty St, Bath, NY 14810. The listed phone number is (607) 382-2525.
What is Marisa Wizeman's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Marisa Wizeman enrolled in Medicare?
Yes. Marisa Wizeman is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Marisa Wizeman was last updated on November 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Miss Marisa Ausborn Wizeman, M.S. · NPI 1104105543
Mental Health provider in Bath, New York. Individual provider, active in the CMS NPPES registry since August 16, 2011.
## Identity
- **NPI:** 1104105543 (Entity type: Individual)
- **Enumerated:** August 16, 2011
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 005318 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 115 LIBERTY ST, Bath, NY 14810-1508
- **Phone:** (607) 382-2525
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
## Record status
- **NPPES last updated:** November 13, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1104105543) · Data from the CMS NPPES public registry.