Provider Demographics
NPI:1932499811
Name:FARN, VENESSA LEE (MS,LPC-SASD,NCC,CTS)
Entity Type:Individual
Prefix:
First Name:VENESSA
Middle Name:LEE
Last Name:FARN
Suffix:
Gender:F
Credentials:MS,LPC-SASD,NCC,CTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 335
Mailing Address - Street 2:
Mailing Address - City:LAKE MILLS
Mailing Address - State:WI
Mailing Address - Zip Code:53551-0335
Mailing Address - Country:US
Mailing Address - Phone:306-240-4570
Mailing Address - Fax:888-972-4891
Practice Address - Street 1:613 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:LAKE MILLS
Practice Address - State:WI
Practice Address - Zip Code:53551-1736
Practice Address - Country:US
Practice Address - Phone:920-988-3372
Practice Address - Fax:888-972-4891
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4567-125104100000X
101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1932499811Medicaid