Provider Demographics
NPI:1477857597
Name:LOVE, VANESSA L (LPC)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:L
Last Name:LOVE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:L
Other - Last Name:KIENOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:76 PROGRESS DRIVE #249D
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-4330
Mailing Address - Country:US
Mailing Address - Phone:203-300-7193
Mailing Address - Fax:
Practice Address - Street 1:76 PROGRESS DRIVE #249D
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901
Practice Address - Country:US
Practice Address - Phone:203-300-7193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-04
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor