Provider Demographics
NPI:1144877739
Name:MEJIAS, VANESSA (LMHC)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:MEJIAS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4019 CLARCONA OCOEE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-4270
Mailing Address - Country:US
Mailing Address - Phone:407-297-1185
Mailing Address - Fax:
Practice Address - Street 1:4019 CLARCONA OCOEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-4270
Practice Address - Country:US
Practice Address - Phone:407-297-1185
Practice Address - Fax:888-694-3421
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16321101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003933900Medicaid