Provider Demographics
NPI:1033202676
Name:ROSAGE, VANESSA W (MS, LMHC, CMHS, LPC)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:W
Last Name:ROSAGE
Suffix:
Gender:F
Credentials:MS, LMHC, CMHS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8140 N MO PAC EXPY
Mailing Address - Street 2:SUITE 135
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8837
Mailing Address - Country:US
Mailing Address - Phone:512-201-4006
Mailing Address - Fax:
Practice Address - Street 1:8140 N MO PAC EXPY
Practice Address - Street 2:SUITE 135
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8837
Practice Address - Country:US
Practice Address - Phone:512-201-4006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00050441101YM0800X
WALH60064961101YM0800X
TX69753101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health