Provider Demographics
NPI:1891532016
Name:NICHOLSON, VANNESSA JENEE (LPC)
Entity type:Individual
Prefix:MRS
First Name:VANNESSA
Middle Name:JENEE
Last Name:NICHOLSON
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 1:1245 SOUTHRIDGE CT STE 202
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-4391
Mailing Address - Country:US
Mailing Address - Phone:469-844-7201
Mailing Address - Fax:
Practice Address - Street 1:1245 SOUTHRIDGE CT STE 2021245
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-4390
Practice Address - Country:US
Practice Address - Phone:469-844-7201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty