Provider Demographics
NPI:1982241824
Name:VANESSA GOEPEL, LPC-S, LLC
Entity type:Organization
Organization Name:VANESSA GOEPEL, LPC-S, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GOEPEL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:205-523-4660
Mailing Address - Street 1:1130 UNIVERSITY BLVD STE B9
Mailing Address - Street 2:BOX 339
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-2984
Mailing Address - Country:US
Mailing Address - Phone:205-523-4660
Mailing Address - Fax:
Practice Address - Street 1:2804 8TH ST STE 102
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-2108
Practice Address - Country:US
Practice Address - Phone:205-523-4660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-10
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty