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General NPI Number Information
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NPI Number | 1235113697
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Entity Type | Individual
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Provider Name | WILLIAM SCOTT VEENSTRA LISW, LICDC
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Gender | Male
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 8351 MENTOR AVE
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City | MENTOR
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State | OH
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Zip | 44060-5749
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Country | US
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Telephone | 216-839-2273
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Fax | 216-896-0735
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Provider Business Mailing Address
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Address Line | PO BOX 24242
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City | CLEVELAND
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State | OH
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Zip | 44124-0242
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Country | US
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Telephone | 216-839-2273
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Fax | 216-896-0735
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | I0004195
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 852101
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License Number State | OH
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