Provider Demographics
NPI:1053450015
Name:JULIE FELD AND ASSOCIATES LLC
Entity Type:Organization
Organization Name:JULIE FELD AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-884-8138
Mailing Address - Street 1:120 S WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-4438
Mailing Address - Country:US
Mailing Address - Phone:920-884-8138
Mailing Address - Fax:920-884-8148
Practice Address - Street 1:120 S WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-4438
Practice Address - Country:US
Practice Address - Phone:920-884-8138
Practice Address - Fax:920-884-8148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3704-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42238500Medicaid