Provider Demographics
NPI:1457645889
Name:DE ALBERDI VISCO, TESSANDRA NOEL (MS, CRC)
Entity Type:Individual
Prefix:MRS
First Name:TESSANDRA
Middle Name:NOEL
Last Name:DE ALBERDI VISCO
Suffix:
Gender:F
Credentials:MS, CRC
Other - Prefix:MISS
Other - First Name:TESSANDRA
Other - Middle Name:NOEL
Other - Last Name:DE ALBERDI PEARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CRC
Mailing Address - Street 1:20 VESPER LN UNIT L1
Mailing Address - Street 2:
Mailing Address - City:NANTUCKET
Mailing Address - State:MA
Mailing Address - Zip Code:02554-4394
Mailing Address - Country:US
Mailing Address - Phone:502-228-2689
Mailing Address - Fax:508-228-3616
Practice Address - Street 1:20 VESPER LN UNIT L1
Practice Address - Street 2:
Practice Address - City:NANTUCKET
Practice Address - State:MA
Practice Address - Zip Code:02554-4394
Practice Address - Country:US
Practice Address - Phone:502-228-2689
Practice Address - Fax:508-228-3616
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health