Individual provider Active NPI

Joel D Fehsenfeld, LCSW

  • Clinical Social Worker
  • Evansville, IN
National Provider Identifier
1548701212
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007435A Issued in IN
Practice address
15 Vann Ave
Evansville, IN 47714-1444
Phone
(812) 402-8333
Fax
(812) 402-8331
NPI assigned
Mar 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

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 34007435A IN Primary

Addresses

Primary practice location

15 Vann Ave
Evansville, IN 47714-1444

Mailing address

PO Box 33
Evansville, IN 47701-0033
Phone (812) 473-0181

Other names 1

  • Jodie Fehsenfeld Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20170328001029 IN Practitioner - Clinical Social Worker 2860777281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

401 SE 6TH St
Suite 110D
Evansville, IN 47713-1215
Phone (812) 773-8988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34007435AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Well Being LLC Clinical CurrentSince Apr 7, 2022 Accepting new patients

Locations

401 SE 6th St
Ste 110D
Evansville, IN 47713
Phone (812) 773-8988

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": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1548701212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477010033",
            "telephone_number": "812-473-0181",
            "fax_number": "812-473-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 VANN AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477141444",
            "telephone_number": "812-402-8333",
            "fax_number": "812-402-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEHSENFELD",
        "first_name": "JOEL",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-15",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007435A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODIE",
            "last_name": "FEHSENFELD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.