FAMILY SERVICES OF NORTHEAST WISCONSIN INC (NPI# 1467453167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467453167 |
| Entity Type | Organization |
| Organization Name | FAMILY SERVICES OF NORTHEAST WISCONSIN INC |
| Other Organization Name | FAMILY SERVICE OF NEW |
| Practice Address |
300 Crooks St Green Bay WI 54301-4527 |
| Mailing Address |
Po Box 22308 Green Bay WI 54305-2308 |
| Practice Telephone | 9204366800 |
| Practice Fax Number | 9204373540 |
| Mailing Telephone | 9204366800 |
| Mailing Fax Number | 9204373540 |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2015-05-18 |
| Authorized Official Name | MR. JEFFREY VANDELEEST (PRESIDENT/CEO) |
| Authorized Official Telephone | 9204366800 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
1329 | WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42105100 | 05 |
| Other Name | Type Code |
|---|---|
| Family Service of NEW | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275525925 | Family Services of Northeast Wisconsin Inc | Clinic/Center | 1810 Appleton Rd, Menasha, WI 54952-1110 | 2005-08-18 |
| Street Address |
300 CROOKS ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-4527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649898636 | Cassondra Frisque | Counselor | 300 Crooks St, Green Bay, WI 54301-4527 | 2020-07-07 |
| 1861011363 | Libbi H Burke | Counselor | 300 Crooks St, Green Bay, WI 54301-4527 | 2020-04-14 |
| 1245870583 | Diana Aguilar | Counselor | 300 Crooks St, Green Bay, WI 54301-4527 | 2020-01-15 |
| 1316594021 | Sophia Marie Hipke | Counselor | 300 Crooks St, Green Bay, WI 54301-4527 | 2019-08-19 |
| 1932642592 | Stacie M Koskinen | Counselor | 300 Crooks St, Green Bay, WI 54301-4527 | 2016-11-29 |
| 1033667217 | Brenda J Malcoreq | Social Worker | 300 Crooks St, Green Bay, WI 54301-4527 | 2016-09-15 |
| 1477903524 | Rebecca Arrowood | Counselor | 300 Crooks St, Green Bay, WI 54301-4527 | 2016-06-20 |
| 1811346745 | Sarah C Thiesfeldt | Social Worker | 300 Crooks St, Green Bay, WI 54301-4527 | 2016-06-10 |
| 1790134625 | Casey M Coughlin | Social Worker | 300 Crooks St, Green Bay, WI 54301-4527 | 2016-06-10 |
| 1730559451 | Angela Gardebrecht | Counselor | 300 Crooks St, Green Bay, WI 54301-4527 | 2015-10-07 |
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| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
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| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
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| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558519462 | Family Services of Northeast Wisconsin | Clinic/Center | 2945 Shawano Ave, Green Bay, WI 54313-6726 | 2008-09-04 |
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| 1578857967 | Aids Resource Center of Wisconsin, Inc. | Clinic/Center | 445 S Adams St, Green Bay, WI 54301-4107 | 2011-06-03 |
| 1942305065 | County of Brown | Clinic/Center | 3150 Gershwin Drive, Green Bay, WI 54311-5859 | 2006-09-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.