Provider Demographics
NPI:1457486573
Name:HOEL, GILFORD C (LCSW, SAC, MS ED)
Entity Type:Individual
Prefix:MR
First Name:GILFORD
Middle Name:C
Last Name:HOEL
Suffix:
Gender:M
Credentials:LCSW, SAC, MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30503 OPUS RD
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:WI
Mailing Address - Zip Code:54651-6537
Mailing Address - Country:US
Mailing Address - Phone:608-337-4465
Mailing Address - Fax:
Practice Address - Street 1:30503 OPUS RD
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:WI
Practice Address - Zip Code:54651-6537
Practice Address - Country:US
Practice Address - Phone:608-337-4465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12669-131101YA0400X
WI2913-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39676600Medicaid