Provider Demographics
NPI:1710692603
Name:OTERO, VANESSA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:
Last Name:OTERO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1400 VILLAGE BLVD APT 523
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-2845
Mailing Address - Country:US
Mailing Address - Phone:201-687-2186
Mailing Address - Fax:
Practice Address - Street 1:111 EXECUTIVE CENTER DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-4849
Practice Address - Country:US
Practice Address - Phone:561-697-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW196061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical