Individual
NEIL C VAN ROSSUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LCSW, CSAC
Contact information
Practice address
W3272 WOLF RIVER DRIVE, KESHENA, WI 54135-9202
(715) 799-3861
(715) 799-3517
Mailing address
MENOMINEE COUNTY HUMAN SERVICES, P.O. BOX 280, KESHENA, WI 54135-0280
(715) 799-3861
(715) 799-3517
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
396123
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
1080-132
WI
104100000X
Social Worker
Primary
396-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39220600
—
WI
Enumeration date
10/05/2006
Last updated
05/10/2019
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