Individual
MS. VANESSA DIANA STATAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2701 INTERNATIONAL LN STE 201, MADISON, WI 53704-3126
(608) 268-6530
(608) 709-1744
Mailing address
815 FORWARD DRIVE, MADISON, WI 53711-2443
(608) 268-6530
(608) 709-1744
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9892-123
WI
Other
Enumeration date
08/07/2019
Last updated
02/04/2026
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