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General NPI Number Information
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NPI Number | 1497840607
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Entity Type | Organization
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Legal Business Name | FOUNDATIONS HEALTH AND WHOLENESS INC
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 09/12/2018
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Provider Practice Location Address
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Address Line | FOUNDATIONS HEALTH AND WHOLENESS INC 1061 W MASON ST.
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City | GREEN BAY
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State | WI
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Zip | 54303-1858
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Country | US
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Telephone | 920-437-8256
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Fax | 920-437-1188
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Provider Business Mailing Address
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Address Line | FOUNDATIONS HEALTH AND WHOLENESS INC 1061 W. MASON ST.
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City | GREEN BAY
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State | WI
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Zip | 54303-1858
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Country | US
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Telephone | 920-437-8256
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Fax | 920-437-1188
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | JULAINE BELINDA FELD
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Credential | LCSW
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Telephone | 920-437-8256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1035
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 1035
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1035
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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