Provider Demographics
NPI:1801971403
Name:SOVEY FAHEY, JENNIFER APRIL (BS MSW LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:APRIL
Last Name:SOVEY FAHEY
Suffix:
Gender:
Credentials:BS MSW LCSW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:APRIL
Other - Last Name:SOVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:916 WILLARD DR STE 125E
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54304-0008
Mailing Address - Country:US
Mailing Address - Phone:920-680-8087
Mailing Address - Fax:
Practice Address - Street 1:916 WILLARD DR STE 125E
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-0008
Practice Address - Country:US
Practice Address - Phone:920-680-8087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7253-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43566800Medicaid