Provider Demographics
NPI:1962742155
Name:PESSIA, NANCY (LICSW)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:PESSIA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 FIELDSTONE WAY
Mailing Address - Street 2:12D
Mailing Address - City:WHITE RIVER JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05001-4580
Mailing Address - Country:US
Mailing Address - Phone:802-295-8505
Mailing Address - Fax:
Practice Address - Street 1:60 FIELDSTONE WAY
Practice Address - Street 2:12D
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05001-4580
Practice Address - Country:US
Practice Address - Phone:802-295-8505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0890050094104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker