MEDICARE: BETHANY SOLBERG

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	12330-123	WI

General Provider Information

NPI Number	:	1629711320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETHANY SOLBERG

Provider Business Mailing Address
First Line	:	2800 E ENTERPRISE AVE STE 333
Second Line	:
City	:	APPLETON
State	:	WI
Zip	:	54913-7889
Country	:	US
Telephone Number	:	414-360-9635
Fax Number	:

Provider Business Practice Location Address
First Line	:	3073 S CHASE AVE STE 310
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53207-2667
Country	:	US
Telephone Number	:	414-360-9635
Fax Number	:

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

Provider Enumeration Date	:	04/19/2022
Last Update Date	:	06/12/2026

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Directions to “ BETHANY SOLBERG ” Practice Location

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