Provider Demographics
NPI:1417776964
Name:VMF THERAPY
Entity type:Organization
Organization Name:VMF THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:FAJOTINA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:267-518-7070
Mailing Address - Street 1:2253 MENLO AVE
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-4739
Mailing Address - Country:US
Mailing Address - Phone:267-518-7070
Mailing Address - Fax:
Practice Address - Street 1:2253 MENLO AVE
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-4739
Practice Address - Country:US
Practice Address - Phone:267-518-7070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health