Provider Demographics
NPI:1902816937
Name:ZULON, VANESSA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:
Last Name:ZULON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6615 SW 113TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1946
Mailing Address - Country:US
Mailing Address - Phone:305-244-0117
Mailing Address - Fax:
Practice Address - Street 1:1492 WEST FLAGLER STREET
Practice Address - Street 2:ROUTE 122
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135
Practice Address - Country:US
Practice Address - Phone:305-541-5864
Practice Address - Fax:305-541-8614
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW87941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical