Provider Demographics
NPI:1003785205
Name:VONFELDT, CORRIE (APSW-IT)
Entity type:Individual
Prefix:
First Name:CORRIE
Middle Name:
Last Name:VONFELDT
Suffix:
Gender:F
Credentials:APSW-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 MARSHALL ST STE A
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-6184
Mailing Address - Country:US
Mailing Address - Phone:715-848-4551
Mailing Address - Fax:
Practice Address - Street 1:2400 MARSHALL ST STE A
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403-6184
Practice Address - Country:US
Practice Address - Phone:715-848-4551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI129033-121101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor