Provider Demographics
NPI:1275818411
Name:VOSSEN, TERESA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:
Last Name:VOSSEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5504 RIVERSIDE HEIGHTS WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-2477
Mailing Address - Country:US
Mailing Address - Phone:607-351-2246
Mailing Address - Fax:
Practice Address - Street 1:135 RIDGECREST RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-9449
Practice Address - Country:US
Practice Address - Phone:607-277-2489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040154901041C0700X
NY0730951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical