Provider Demographics
NPI:1619609435
Name:WASZKIEWICZ, VANESSA DENISE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:DENISE
Last Name:WASZKIEWICZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 MOCKINGBIRD AVE SW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32908-4900
Mailing Address - Country:US
Mailing Address - Phone:321-307-3363
Mailing Address - Fax:
Practice Address - Street 1:3200 MOCKINGBIRD AVE SW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32908-4900
Practice Address - Country:US
Practice Address - Phone:321-307-3363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-29
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH20665101YM0800X
FLMH22438101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health