Provider Demographics
NPI:1346584224
Name:BRACKETT, VANESSA LEE
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:LEE
Last Name:BRACKETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ATWOOD DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060
Mailing Address - Country:US
Mailing Address - Phone:413-582-0471
Mailing Address - Fax:413-585-9765
Practice Address - Street 1:8 ATWOOD DR.
Practice Address - Street 2:SUITE 201
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060
Practice Address - Country:US
Practice Address - Phone:413-582-0471
Practice Address - Fax:413-585-9765
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health