Individual
DENNIS J VANDERMAUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
615 E WALL ST, EAGLE RIVER, WI 54521
(715) 479-2600
Mailing address
PO BOX 1062, HAYWARD, WI 54843-1062
(715) 558-4901
(715) 634-1722
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3580-123
WI
1041C0700X
Clinical Social Worker
LW00009372
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39223400
—
WI
Enumeration date
09/14/2007
Last updated
06/13/2025
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