Provider Demographics
NPI:1518581107
Name:STEFFENS, VANESSA (MA)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:STEFFENS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2366 ROLLING FORK CIR APT 406
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-5321
Mailing Address - Country:US
Mailing Address - Phone:561-789-4920
Mailing Address - Fax:
Practice Address - Street 1:124 E BROAD ST STE D
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4530
Practice Address - Country:US
Practice Address - Phone:703-672-3857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-30
Last Update Date:2020-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704013037101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0704013037OtherOUT OF NETWORK