Provider Demographics
NPI:1679236202
Name:ZIKOVSKY, VANESSA LORAIN (LMHC)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:LORAIN
Last Name:ZIKOVSKY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:ARANGUA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6212 FRIENDS AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-3726
Mailing Address - Country:US
Mailing Address - Phone:865-964-3780
Mailing Address - Fax:
Practice Address - Street 1:6212 FRIENDS AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-3726
Practice Address - Country:US
Practice Address - Phone:865-964-3780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009195101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty