Provider Demographics
NPI:1578009080
Name:VEASEY, ANNETTE L (MSW)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:L
Last Name:VEASEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4222 W CAPITOL DR STE 308
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2500
Mailing Address - Country:US
Mailing Address - Phone:262-343-5609
Mailing Address - Fax:414-249-3312
Practice Address - Street 1:4222 W CAPITOL DR STE 308
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216
Practice Address - Country:US
Practice Address - Phone:414-231-9996
Practice Address - Fax:414-249-3312
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-09
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1578009080Medicaid