Provider Demographics
NPI:1023382413
Name:POITIER, VANESTA LOUISE (LICSW)
Entity Type:Individual
Prefix:
First Name:VANESTA
Middle Name:LOUISE
Last Name:POITIER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9285 LIVERY LN
Mailing Address - Street 2:APT C
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1618
Mailing Address - Country:US
Mailing Address - Phone:240-280-4890
Mailing Address - Fax:
Practice Address - Street 1:9285 LIVERY LN
Practice Address - Street 2:APT C
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-1618
Practice Address - Country:US
Practice Address - Phone:240-280-4890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3027831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical