Provider Demographics
NPI:1962564369
Name:LAABS SIEMON, VALERIE J (MS)
Entity type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:J
Last Name:LAABS SIEMON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 E LILAC LN
Mailing Address - Street 2:
Mailing Address - City:FOX POINT
Mailing Address - State:WI
Mailing Address - Zip Code:53217-2956
Mailing Address - Country:US
Mailing Address - Phone:414-378-9899
Mailing Address - Fax:414-963-9008
Practice Address - Street 1:1107 E LILAC LN
Practice Address - Street 2:
Practice Address - City:FOX POINT
Practice Address - State:WI
Practice Address - Zip Code:53217-2956
Practice Address - Country:US
Practice Address - Phone:414-378-9899
Practice Address - Fax:414-963-9008
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TP0814X
WI43124106H00000X
WI2527125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39604800Medicaid
WI11637472OtherCAQH