Provider Demographics
NPI:1700304417
Name:O'SHEA, VANESSA (MSW,LMSW)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:O'SHEA
Suffix:
Gender:F
Credentials:MSW,LMSW
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:BLAIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW,LMSW
Mailing Address - Street 1:111 COLCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1473
Mailing Address - Country:US
Mailing Address - Phone:802-847-0000
Mailing Address - Fax:
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT156-0132141104100000X
VT089.0134488104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker