Individual provider Active NPI

Patricia N Fedie, LCSW

  • Clinical Social Worker
  • Eau Claire, WI
National Provider Identifier
1255401709
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7299123 Issued in WI
Practice address
2620 Stein Blvd
Eau Claire, WI 54701-6201
Phone
(715) 836-0064
Fax
(715) 836-0065
NPI assigned
Nov 9, 2006
Last updated
Nov 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7299123 WI Primary

Addresses

Primary practice location

2620 Stein Blvd
Eau Claire, WI 54701-6201

Mailing address

2620 Stein Blvd
Eau Claire, WI 54701-6201
Phone (715) 836-0064

Other identifiers 1

IdentifierTypeStateIssuer
43598500MedicaidWI

Other names 1

  • Patricia E Nunke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080530000796 WI Practitioner - Clinical Social Worker 9638249899 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Collaborative Counseling LLCGroup PAC ID 3678711900, 43 clinicians

Practice addresses (Care Compare)

2115 E Clairemont Ave
Suite 2
Eau Claire, WI 54701-4761
Phone (763) 210-9966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7299123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Collaborative Counseling LLC CurrentSince Jan 14, 2025 Accepting new patients
Caillier Clinic LTD Clinical CurrentSince Apr 22, 2008 Accepting new patients

Locations

12918 63rd Ave N
Maple Grove, MN 55369
Phone (763) 210-9983

2115 E Clairemont Ave
Ste 2
Eau Claire, WI 54701
Phone (507) 993-0437

2620 Stein Blvd
Eau Claire, WI 54701
Phone (715) 831-0100

901 4th St
Hudson, WI 54016
Phone (651) 492-8498

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1255401709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 STEIN BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016201",
            "telephone_number": "715-836-0064",
            "fax_number": "715-836-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 STEIN BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016201",
            "telephone_number": "715-836-0064",
            "fax_number": "715-836-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDIE",
        "first_name": "PATRICIA",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7299123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43598500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "NUNKE",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eau Claire, WI

Sources for this page

Verify at the official NPI Registry.