Provider Demographics
NPI:1902796030
Name:MONGE, VANESSA (SW)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:MONGE
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22501 95TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-3808
Mailing Address - Country:US
Mailing Address - Phone:646-796-5059
Mailing Address - Fax:
Practice Address - Street 1:22501 95TH AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-3808
Practice Address - Country:US
Practice Address - Phone:646-796-5059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127601104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker