Active NPI
Jennifer Vanrossum, LPC
- Professional Counselor
- Waukesha, WI
National Provider Identifier
1720100688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3614-125
- Practice address
- 741 N Grand Ave
Suite 302
Waukesha, WI 53186-4820 - Phone
- (262) 542-3255
- NPI assigned
- Apr 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3614-125 | WI | Primary |
Addresses
Primary practice location
741 N Grand Ave
Suite 302
Waukesha, WI 53186-4820
Mailing address
W283 N6297 Hibritten Way
Hartland, WI 53029
Phone (773) 502-1023
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3614-125 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cornerstone Counseling Services | Past | Accepting new patients | |
| Cornerstone Counseling Services, Inc | Past | Accepting new patients |
Interoperability endpoints
- lifestancehealth.jennifervanrossum@149809.advancedmd-direct.com
Organizations & group practices 2
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.
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-
- Mental Health Counselor
- Brookfield, WI
- NPI 1033127246
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720100688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W283 N6297 HIBRITTEN WAY",
"city": "HARTLAND",
"state": "WI",
"postal_code": "53029",
"telephone_number": "773-502-1023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "741 N GRAND AVE",
"address_2": "SUITE 302",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531864820",
"telephone_number": "262-542-3255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANROSSUM",
"first_name": "JENNIFER",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "3614-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukesha, WI
Sources for this page
- 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.