Provider Demographics
NPI:1760718886
Name:VERONA COUNSELING ASSOCIATES
Entity Type:Organization
Organization Name:VERONA COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:CASALI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:608-848-2574
Mailing Address - Street 1:111 E VERONA AVE
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-1218
Mailing Address - Country:US
Mailing Address - Phone:608-848-2574
Mailing Address - Fax:608-848-2574
Practice Address - Street 1:111 E VERONA AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-1218
Practice Address - Country:US
Practice Address - Phone:608-848-2574
Practice Address - Fax:608-848-2574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1741-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43710100Medicaid