Justine Cleveland
Individual provider Active NPI Social Worker · Aniwa, WI
NPI 1215492053 · NPPES record last updated Apr 8, 2020
Key facts
- NPI
- 1215492053
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 9124123 (WI)
- Practice address
- 242031 County Road Y
Aniwa, WI 54408-5047 - Phone
- (715) 297-8745
- NPI assigned
- Feb 6, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9124123 | WI | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wholehearted Herd Counseling, LLC | Social Worker | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 9124123 | WI | Yes |
Addresses
Primary practice location
242031 County Road Y
Aniwa, WI 54408-5047
Mailing address
242031 County Road Y
Aniwa, WI 54408-5047
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | contact@wholeheartedherdcounseling.com | Direct |
Other providers in Aniwa, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.