Provider Demographics
NPI:1295121739
Name:CHAFOS, VANESSA H (PHD)
Entity type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:H
Last Name:CHAFOS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 629
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08542-0629
Mailing Address - Country:US
Mailing Address - Phone:908-516-8422
Mailing Address - Fax:
Practice Address - Street 1:257 US HIGHWAY 22 STE B
Practice Address - Street 2:
Practice Address - City:GREEN BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08812-1807
Practice Address - Country:US
Practice Address - Phone:908-516-8422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-11
Last Update Date:2023-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00515300101YP2500X
NJ35SI00709100103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional