Provider Demographics
NPI:1316791692
Name:DA SILVEIRA, VANESSA BOMJARDIM (LMFT)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:BOMJARDIM
Last Name:DA SILVEIRA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 KENNETH AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-3113
Mailing Address - Country:US
Mailing Address - Phone:908-764-3643
Mailing Address - Fax:
Practice Address - Street 1:939 KENNETH AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-3113
Practice Address - Country:US
Practice Address - Phone:908-764-3643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37FA00021100106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist