Provider Demographics
NPI:1235928227
Name:LAMISON, VANESSA ARTRICE
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:ARTRICE
Last Name:LAMISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11073 CORVIN PL
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-4302
Mailing Address - Country:US
Mailing Address - Phone:631-372-9330
Mailing Address - Fax:
Practice Address - Street 1:6100 RADIO STATION RD
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-3314
Practice Address - Country:US
Practice Address - Phone:301-645-3090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16109101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor