MEDICARE: JULIE FELD AND ASSOCIATES LLC

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	1041C0700X	Clinical Social Worker	3704-123	WI

Other Identifiers

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

General Provider Information

NPI Number	:	1053450015
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JULIE FELD AND ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	120 S WEBSTER AVE
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54301-4438
Country	:	US
Telephone Number	:	920-884-8138
Fax Number	:	920-884-8148

Provider Business Practice Location Address
First Line	:	120 S WEBSTER AVE
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54301-4438
Country	:	US
Telephone Number	:	920-884-8138
Fax Number	:	920-884-8148

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JULIE FELD
Credential	:
Telephone Number	:	920-884-8138

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	08/22/2020

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