Provider Demographics
NPI:1770095630
Name:VANESSA Y. ORTIZ, LMFT, PLLC
Entity type:Organization
Organization Name:VANESSA Y. ORTIZ, LMFT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE & THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:860-952-4051
Mailing Address - Street 1:150 HILLCREST AVE APT B
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06110-2263
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 HILLCREST AVE APT B
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06110-2263
Practice Address - Country:US
Practice Address - Phone:860-952-4051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1718106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty