Provider Demographics
NPI:1447143029
Name:SAUCEDO, VANESSA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:MARIE
Last Name:SAUCEDO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 ROSEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-5716
Mailing Address - Country:US
Mailing Address - Phone:936-899-0833
Mailing Address - Fax:
Practice Address - Street 1:310 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-5123
Practice Address - Country:US
Practice Address - Phone:936-272-0555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX693941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical