Provider Demographics
NPI:1356515126
Name:NEUENFELDT, DENNIS JAMES (LCSW, LMFT)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:JAMES
Last Name:NEUENFELDT
Suffix:
Gender:M
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W350S1401 WATERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:DOUSMAN
Mailing Address - State:WI
Mailing Address - Zip Code:53118-9020
Mailing Address - Country:US
Mailing Address - Phone:262-965-9457
Mailing Address - Fax:
Practice Address - Street 1:W350S1401 WATERVILLE RD
Practice Address - Street 2:
Practice Address - City:DOUSMAN
Practice Address - State:WI
Practice Address - Zip Code:53118-9020
Practice Address - Country:US
Practice Address - Phone:262-965-9457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2543-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39717500Medicaid