Provider Demographics
NPI:1831577980
Name:BONAPARTE, VANESSA H (LPC)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:H
Last Name:BONAPARTE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 ENTERPRISE PATH
Mailing Address - Street 2:SUITE 305
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-2689
Mailing Address - Country:US
Mailing Address - Phone:678-653-8739
Mailing Address - Fax:678-653-8739
Practice Address - Street 1:107 ENTERPRISE PATH
Practice Address - Street 2:SUITE 305
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-2689
Practice Address - Country:US
Practice Address - Phone:678-653-8739
Practice Address - Fax:678-653-8739
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-09
Last Update Date:2015-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007636101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional