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NPI Code Detail

MEDICARE: JUDITH A. FELD LCSW

MEDICARE:   JUDITH A. FELD  LCSW
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
11041C0700XClinical Social Worker1506-123WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366603896
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDITH A. FELD LCSW
Provider Business Mailing Address
First Line : PO BOX 19070
Second Line :
City : GREEN BAY
State : WI
Zip : 54307-9070
Country : US
Telephone Number : 920-496-4700
Fax Number :
Provider Business Practice Location Address
First Line : 2680 VERNON DR
Second Line :
City : GREEN BAY
State : WI
Zip : 54304-5374
Country : US
Telephone Number : 920-496-4700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2008
Last Update Date : 10/06/2017

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Directions to “ JUDITH A. FELD LCSW” Practice Location

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