Provider Demographics
NPI:1598006066
Name:PLACERES, VANESSA (LPC, RPT, NCC)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:
Last Name:PLACERES
Suffix:
Gender:F
Credentials:LPC, RPT, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 JACKSON ST NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1303
Mailing Address - Country:US
Mailing Address - Phone:706-688-9886
Mailing Address - Fax:
Practice Address - Street 1:180 JACKSON ST NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1303
Practice Address - Country:US
Practice Address - Phone:209-609-7958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-08
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1608746101YS0200X
GA009126101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1608746OtherPROFESSIONAL SCHOOL COUNSELOR K-12
GA009126OtherLICENSED PROFESSIONAL COUNSELOR (LPC)
CAT4915OtherREGISTERED PLAY THERAPIST