Provider Demographics
NPI:1750166054
Name:ADAMS, VANESSA M (LICSW)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:M
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:MICHELLE
Other - Last Name:REESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2116 22ND CT SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-8612
Mailing Address - Country:US
Mailing Address - Phone:360-580-1521
Mailing Address - Fax:
Practice Address - Street 1:2116 22ND CT SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-8612
Practice Address - Country:US
Practice Address - Phone:360-580-1521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA612039341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical