Fennema, Virginia V

Fennema, Virginia V is an sole proprietor health care provider with primary practice located at 6121 Green Bay Rd Suite 220, Kenosha WI 53142-2926. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Fennema, Virginia V can be contacted via phone (262) 652-7222.

Contact Information

Primary practice address
6121 Green Bay Rd Suite 220 Kenosha WI 53142-2926
Phone: (262) 652-7222
Fax: (262) 652-1734
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 1507-123 Wisconsin

Profile Details

NPI number 1376560946
LBN Legal business name Fennema, Virginia V
Credentials MSW, LCSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 17th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1376560946 NPPES
Wisconsin Other 175724 VALUE OPTIONS
Wisconsin MEDICAID 39296200 VALUE OPTIONS
Wisconsin Other 467366 VALUE OPTIONS

Popular Providers