Provider Demographics
NPI:1184267833
Name:PATE, VANESSA (MA LPC)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:PATE
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 BELLA DONNA
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77381-5015
Mailing Address - Country:US
Mailing Address - Phone:713-376-0427
Mailing Address - Fax:
Practice Address - Street 1:102 BELLA DONNA
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77381-5015
Practice Address - Country:US
Practice Address - Phone:713-376-0427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70341101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty