Vanessa Diana Statam, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9892-123 Issued in WI

Practice address

2701 International LN Ste 201
Madison, WI 53704-3126

Phone

(608) 268-6530

Fax

(608) 709-1744

NPI assigned

Aug 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Vanessa Diana Bush Former name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Anesis Center for Marriage and Family Therapy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, WI
  • NPI 1720586761
  Medicare reassignment
• Anesis Foundation for Mental Health Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, WI
  • NPI 1750255162
  NPD

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1659926509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 FORWARD DRIVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112443",
            "telephone_number": "608-268-6530",
            "fax_number": "608-709-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 INTERNATIONAL LN STE 201",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537043126",
            "telephone_number": "608-268-6530",
            "fax_number": "608-709-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATAM",
        "first_name": "VANESSA",
        "middle_name": "DIANA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9892-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "BUSH",
            "middle_name": "DIANA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicole I Stasiewicz, RN
• Rene E Staskal, PHD
• Paul A Staskowski, MD
• Jenea Kathleen Stassi, BSN, WCC
• Katie L Stassi
• State of Wisconsin
• State of Wisconsin
• State of Wisconsin
• State of Wisconsin
• State of Wisconsin

• Clinical Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.