Virginia V Fennema, MSW, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1507-123 Issued in WI

Practice address

6121 Green Bay Rd
Suite 220
Kenosha, WI 53142-2926

Phone

(262) 652-7222

Fax

(262) 652-1734

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376560946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6121 GREEN BAY RD",
            "address_2": "SUITE 220",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531422926",
            "telephone_number": "262-652-7222",
            "fax_number": "262-652-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 GREEN BAY RD",
            "address_2": "SUITE 220",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531422926",
            "telephone_number": "262-652-7222",
            "fax_number": "262-652-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNEMA",
        "first_name": "VIRGINIA",
        "middle_name": "V",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "1507-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "175724",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39296200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "467366",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zebi Fatima, MD
• Leah J Featherstone, PSYD
• Tarah A Fedenia
• Benjamin A Feinzimer, D.O.
• Scott R Feldy, DO
• Karen Marie Fenske, NNP, APNP
• Linda M. Fenske, L.P.N.
• Carolyn M Ferda, LPC-IT
• Jeff Fernholz, HIS
• Julie Ferraro

• Mental Health Counselor in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.