Provider Demographics
NPI:1841967460
Name:SMITH, VANNESSA R (MSW)
Entity type:Individual
Prefix:
First Name:VANNESSA
Middle Name:R
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:VANNESSA
Other - Middle Name:R
Other - Last Name:BURGESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:177 CLIMBING VINE AVE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-3947
Mailing Address - Country:US
Mailing Address - Phone:302-415-1109
Mailing Address - Fax:
Practice Address - Street 1:230 N UNION ST
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-1151
Practice Address - Country:US
Practice Address - Phone:302-508-2233
Practice Address - Fax:302-508-5381
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health