Elizabeth Fettig, MSW
Individual provider Active NPI Clinical Social Worker · Prairie Du Sac, WI
NPI 1891991360 · NPPES record last updated Nov 2, 2023
Key facts
- NPI
- 1891991360
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 9205-123 (WI)
- Practice address
- 50 Prairie Ave
Prairie Du Sac, WI 53578-1541 - Phone
- (608) 643-3147
- Fax
- (608) 643-3178
- NPI assigned
- Jun 22, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9205-123 | WI | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | 9205-123 | WI | Yes |
Addresses
Primary practice location
50 Prairie Ave
Prairie Du Sac, WI 53578-1541
Mailing address
25 Kessel CT Ste 105
Madison, WI 53711-6227
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891991360 | Medicaid | WI |
Other names
- Beth Fettig
Other providers in Prairie Du Sac, WI
- Scott A Ensminger
- Andrew Ertl
- Jeffrey J Everson
- Ann M Evert
- Margaret Owen Faludi
- Kari Fisher
- James Edward Force
- Foremost Physical Therapy LLC
- Joellen E Frawley
- Brenda Kay Fronsee
All providers in Prairie Du Sac, WI · Clinical Social Worker in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.