Heather A Beaudoin, LCSW

Individual provider Active NPI Clinical Social Worker · Kaukauna, WI

NPI 1700414489 · NPPES record last updated May 27, 2026

Key facts

NPI
1700414489
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
10143-123 (WI)
Practice address
120 E 4TH St
Kaukauna, WI 54130-2522
Phone
(920) 520-2525
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
10143-123WIMDClinical Social Worker
10143WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catalpa Health Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10143-123 WI Yes

Addresses

Primary practice location

120 E 4TH St
Kaukauna, WI 54130-2522

Mailing address

120 E 4TH St
Kaukauna, WI 54130-2522

Other providers in Kaukauna, WI

All providers in Kaukauna, WI · Clinical Social Worker in Wisconsin

Sources for this page

Verify at the official NPI Registry.