Provider Demographics
NPI:1013159052
Name:VANLEY, NANCY J (MA, LPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:J
Last Name:VANLEY
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 TOWER DR STE 19
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-4251
Mailing Address - Country:US
Mailing Address - Phone:432-889-2244
Mailing Address - Fax:
Practice Address - Street 1:835 TOWER DR STE 19
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4251
Practice Address - Country:US
Practice Address - Phone:432-889-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62450101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor