MS. DOROTHY A FONSTAD (NPI# 1639246382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639246382 |
| Entity Type | Individual |
| Full Name | MS. DOROTHY A FONSTAD |
| Credential | MSE, LCSW, CADC 111 |
| Practice Address |
711 N Lynndale Dr Ste 1a Appleton WI 54914-3078 |
| Mailing Address |
3521 N Morrison St Appleton WI 54911-1251 |
| Practice Telephone | 9205604525 |
| Practice Fax Number | 9205606618 |
| Mailing Telephone | 7152143679 |
| Mailing Fax Number | 9205606618 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2018-02-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | 3182-123 | WI | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1554 | WI | Behavioral Health & Social Service Providers |
| Y | 104100000X | Social Worker | 3182 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39787600 | 05 |
| Street Address |
711 N LYNNDALE DR STE 1A |
| City | APPLETON |
| State | WI |
| Zip Code | 54914-3078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811391 | Kari Beth Steffes | Psychiatry & Neurology | 711 N Lynndale Dr Ste 1a, Appleton, WI 54914-3078 | 2020-11-03 |
| 1346741345 | Korah Lee Petrasko | Counselor | 711 N Lynndale Dr Ste 1a, Appleton, WI 54914-3078 | 2018-02-24 |
| 1336658285 | Jillian Rotzenberg | Counselor | 711 N Lynndale Dr Ste 1a, Appleton, WI 54914-3078 | 2017-09-22 |
| 1659711687 | Gjb Health Services, LLC | Counselor | 711 N Lynndale Dr Ste 1a, Appleton, WI 54914-3078 | 2013-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518572429 | Claire Schuh | Social Worker | 3416 Association Ln, Appleton, WI 54914 | 2020-09-09 |
| 1568099729 | Access Elevator, Inc. | Contractor | 1314 W. College Ave, Appleton, WI 54914 | 2020-03-26 |
| 1124677885 | Sharon Darla Cornell | Technician | 3117 N. Mistwood Lane, Appleton, WI 54914 | 2019-09-05 |
| 1235647793 | Midwest Monitoring, LLC | Psychiatry & Neurology | 4321 W College Ave Ste 200, Appleton, WI 54914 | 2018-01-18 |
| 1356863252 | Uvanta Pharmacy LLC | Pharmacy | 1050 S Grider St, Suite C, Appleton, WI 54914 | 2017-07-12 |
| 1255860912 | Appleton Counseling Management LLC | Counselor | 477 S Nicolet Rd., Appleton, WI 54914 | 2017-06-07 |
| 1609269489 | Shane Scott Urban | Social Worker | 444 N. Westhill Blvd., Appleton, WI 54914 | 2015-03-18 |
| 1699184580 | Michelle Becker | Nurse Practitioner | 4435 West Lawrence St., Appleton, WI 54914 | 2014-08-05 |
| 1972857514 | Jean Flesch | Pharmacist | 1000 W. Northland Ave., Appleton, WI 54914 | 2012-11-05 |
| 1477845147 | Mallory Barbara Herrin | Counselor | 820 W. College Ave, Appleton, WI 54914 | 2011-05-12 |
| Find all providers in zip 54914 | ||||
| Taxonomy Code | 104100000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. |
| Notes: Source: National Association of Social Workers, 2009 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518572429 | Claire Schuh | Social Worker | 3416 Association Ln, Appleton, WI 54914 | 2020-09-09 |
| 1780225292 | Jenny Jamison | Social Worker | 1011 N Lynndale Dr, Appleton, WI 54914-3091 | 2019-10-05 |
| 1871085480 | Tanya Lynn Vickery | Social Worker | 410 S. Elm St., Appleton, WI 54911 | 2018-05-31 |
| 1336689314 | Samantha N Larson | Social Worker | 442 N Westhill Blvd, Appleton, WI 54914-5715 | 2017-02-24 |
| 1861696619 | Jennifer L Bushman | Social Worker | 444 N. Westhill Blvd, Appleton, WI 54914-5715 | 2007-06-14 |
| 1386243129 | Kia Thao | Social Worker | 320 S Walnut St, Appleton, WI 54911-5918 | 2020-10-22 |
| 1386241784 | Caitlin Simonsmeier | Social Worker | 3003 N Richmond St, Appleton, WI 54911-1148 | 2020-10-08 |
| 1134738594 | Lauren Sankey | Social Worker | 4635 W College Ave, Appleton, WI 54914-8507 | 2020-07-30 |
| 1922626431 | Carmen Meuret | Social Worker | 4635 W College Ave, Appleton, WI 54914-8507 | 2020-07-10 |
| 1174152318 | Rochelle A Kottke | Social Worker | 320 S Walnut St, Appleton, WI 54911-5918 | 2020-04-08 |
| Find all providers in APPLETON | ||||
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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.