MEDICARE: KIM NEAL SOCIAL WORKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	4521-120	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4521-120	OTHER	WI	LICENSE NUMBER

General Provider Information

NPI Number	:	1134214182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM NEAL SOCIAL WORKER

Provider Business Mailing Address
First Line	:	333 E WASHINGTON ST
Second Line	:	SUITE 2000
City	:	WEST BEND
State	:	WI
Zip	:	53095-2585
Country	:	US
Telephone Number	:	262-335-4545
Fax Number	:	262-335-6827

Provider Business Practice Location Address
First Line	:	333 E WASHINGTON ST
Second Line	:	SUITE 2000
City	:	WEST BEND
State	:	WI
Zip	:	53095-2585
Country	:	US
Telephone Number	:	262-335-4545
Fax Number	:	262-335-6827

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	05/31/2026

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Directions to “ KIM NEAL SOCIAL WORKER” Practice Location

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