Deborah L Wald, LSW
Individual provider Active NPI Case Manager/Care Coordinator · Balsam Lake, WI
NPI 1457575508 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1457575508
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- License
- 348 120 (WI)
- Practice address
- 100 Polk County PLZ
Suite 50
Balsam Lake, WI 54810-9071 - Phone
- (715) 485-8424
- Fax
- (715) 485-8490
- NPI assigned
- Apr 12, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 348 120 | WI | MD | Case Manager/Care Coordinator |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 348 120 | WI | Yes |
Addresses
Primary practice location
100 Polk County PLZ
Suite 50
Balsam Lake, WI 54810-9071
Mailing address
24150 Range Line Rd
Grantsburg, WI 54840-8100
Phone (715) 689-2212
Other providers in Balsam Lake, WI
- Nancy Lee Stewart
- Tjzarn Ventures LLC
- Diane M Torres
- Unity Pharmacy, LLC
- Diane M Voltz
- Western Region Recovery & Wellness Consortia
- Marci A Wicklund-Allee
- Tammy Jo Zarn
All providers in Balsam Lake, WI · Case Manager/Care Coordinator in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.