| Doctor Name: | NEIL C VAN ROSSUM |
| NPI Number: | 1366538712 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS CADC |
| License Number: | 957125 |
| Business Practice Address: | 1415 E Green Bay St Ste 191 Shawano, WI - 541663879 |
| Business Phone Number: | 7155265466 |
| Business Fax Number: | 7155265545 |
| Mailing Address: | 1415 E Green Bay St, Ste 191 SHAWANO |
| State: | WI |
| Postal Code: | 541663879 |
| Phone Number: | 7155265466 |
| Fax Number: | 7155265545 |
| NPI Enumeration Date: | 10/05/2006 |
| NPI Last Update Date: | 03/05/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 957125 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |