Provider Demographics
NPI:1730561333
Name:LAROSE, VANESSA (MS, LPC-T)
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:
Last Name:LAROSE
Suffix:
Gender:F
Credentials:MS, LPC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N OAK AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-5703
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2727 PLAZA DR
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4129
Practice Address - Country:US
Practice Address - Phone:715-847-3000
Practice Address - Fax:715-358-9556
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIQTT106H00000X
WI7483-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist