Individual provider Active NPI

Erica Marie Dobberfuhl, LCSW

  • Clinical Social Worker
  • Appleton, WI
National Provider Identifier
1508676362
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9712-123 Issued in WI
Practice address
10 Tri Park Way
Appleton, WI 54914-1658
Phone
(920) 831-0070
NPI assigned
Jan 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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 9712-123 WI Primary

Addresses

Primary practice location

10 Tri Park Way
Appleton, WI 54914-1658

Mailing address

Clement J Zablocki Vamc 5000 W National Avenue
Milwaukee, WI 53295-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9712-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Milwaukee Vamc CurrentSince Jan 19, 2025 Accepting new patients

Locations

10 Tri Park Way
Appleton, WI 54914
Phone (920) 831-7990

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1508676362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CLEMENT J ZABLOCKI VAMC 5000 W NATIONAL AVENUE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532950001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TRI PARK WAY",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549141658",
            "telephone_number": "920-831-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBBERFUHL",
        "first_name": "ERICA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9712-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; 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.