Provider Demographics
NPI:1427297183
Name:FIFIELD, AMY MARIE (LPC SASA)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MARIE
Last Name:FIFIELD
Suffix:
Gender:
Credentials:LPC SASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 FREEDOM RD STE A
Mailing Address - Street 2:
Mailing Address - City:LITTLE CHUTE
Mailing Address - State:WI
Mailing Address - Zip Code:54140-3200
Mailing Address - Country:US
Mailing Address - Phone:920-460-9009
Mailing Address - Fax:
Practice Address - Street 1:1800 FREEDOM RD STE A
Practice Address - Street 2:
Practice Address - City:LITTLE CHUTE
Practice Address - State:WI
Practice Address - Zip Code:54140-3200
Practice Address - Country:US
Practice Address - Phone:920-460-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15529-130101YA0400X
WI265-226101YM0800X
WI4299-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100007727Medicaid
WI1427297183OtherNPI