Healthcare Provider Details

I. General information

NPI: 1467087429
Provider Name (Legal Business Name): VANESSA VERRAN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2020
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
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: 608-601-8300
  • Fax:
Mailing address:
  • Phone: 608-280-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1402124
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: