Provider Demographics
NPI:1245729441
Name:BESSA, LAUREN K (MSW LCSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:K
Last Name:BESSA
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:K
Other - Last Name:BISCOBING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 LAKE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-6799
Mailing Address - Country:US
Mailing Address - Phone:715-848-4600
Mailing Address - Fax:715-845-5398
Practice Address - Street 1:1225 LANGLADE RD
Practice Address - Street 2:
Practice Address - City:ANTIGO
Practice Address - State:WI
Practice Address - Zip Code:54409-2762
Practice Address - Country:US
Practice Address - Phone:715-627-6694
Practice Address - Fax:715-845-5398
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI130665104100000X
WI93471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker