Provider Demographics
NPI:1245374842
Name:ROOF, VANESSA L (LMHP, LPC)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:L
Last Name:ROOF
Suffix:
Gender:F
Credentials:LMHP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 O ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2646
Mailing Address - Country:US
Mailing Address - Phone:402-476-6060
Mailing Address - Fax:402-476-6809
Practice Address - Street 1:8101 O ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2646
Practice Address - Country:US
Practice Address - Phone:402-476-6060
Practice Address - Fax:402-476-6809
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2869101YM0800X
NE1499101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025071300Medicaid