Healthcare Provider Details

I. General information

NPI: 1295211837
Provider Name (Legal Business Name): VICTORIA ANN CLAAS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VICTORIA CLARK

II. Dates (important events)

Enumeration Date: 07/17/2018
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5315 WALL ST STE 290
MADISON WI
53718-7965
US

IV. Provider business mailing address

5315 WALL ST STE 290
MADISON WI
53718-7965
US

V. Phone/Fax

Practice location:
  • Phone: 608-236-4460
  • Fax:
Mailing address:
  • Phone: 608-236-4460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12512-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: