Provider Demographics
NPI:1275147092
Name:VANESSA AH LI PSYCHOLOGY SERVICES PLLC
Entity Type:Organization
Organization Name:VANESSA AH LI PSYCHOLOGY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:646-626-6640
Mailing Address - Street 1:165 W 91ST ST APT 7A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1356
Mailing Address - Country:US
Mailing Address - Phone:410-965-6306
Mailing Address - Fax:
Practice Address - Street 1:115 W 30TH ST RM 709
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4068
Practice Address - Country:US
Practice Address - Phone:646-626-6640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty