Provider Demographics
NPI:1962053892
Name:MCDOWELL, VANESSA (CADC)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 HECKS PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-8423
Mailing Address - Country:US
Mailing Address - Phone:606-462-1327
Mailing Address - Fax:
Practice Address - Street 1:505 HECKS PLAZA DR
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-8423
Practice Address - Country:US
Practice Address - Phone:606-462-1327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY171616101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)