Tabitha Ann Fendrick, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801091940 Issued in MI

Practice address

2500 Hall Ave
Marinette, WI 54143-1655

Phone

(715) 732-7700

Fax

(715) 732-7667

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• County of Marinette

  • Non-Surgical Family Planning Clinic/Center
  • Marinette, WI
  • NPI 1568531267
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381449600000",
    "number": "1366535957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 HALL AVE",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431655",
            "telephone_number": "715-732-7700",
            "fax_number": "715-732-7667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HALL AVE",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431655",
            "telephone_number": "715-732-7700",
            "fax_number": "715-732-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENDRICK",
        "first_name": "TABITHA",
        "middle_name": "ANN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2013-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801091940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WISCONSIN DSPS",
            "identifier": "8072-123",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "TF085506",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chad Ermis, DO
• Emily B Ermis, D.O.
• Sohan Erpenwar
• Family Care Medical Clinic
• Sharon L Fellion, RNC WHNP
• Tadeusz Filon, PT
• Lisa M Fischer, PHYSICAL THERAPIST
• Richard Patrick Fisher, D.D.S., M.S.
• Willis Fisher, CRNA
• Jessica Marie Flaeschel, APNP

• Clinical Social Worker in Marinette, WI
• Providers in Marinette, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.