Provider Demographics
NPI:1265748024
Name:SLIVKEN, VANESSA JOSEPHINE (MA, LMFT)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:JOSEPHINE
Last Name:SLIVKEN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:JOSEPHINE
Other - Last Name:SPAWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3395 PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-3633
Mailing Address - Country:US
Mailing Address - Phone:952-548-8789
Mailing Address - Fax:
Practice Address - Street 1:3395 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-3633
Practice Address - Country:US
Practice Address - Phone:952-548-8789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1930106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist