Provider Demographics
NPI:1538737150
Name:PACHECO, VANESSA (MA, LLPC)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:PACHECO
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34474 23 MILE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-2003
Mailing Address - Country:US
Mailing Address - Phone:586-996-2273
Mailing Address - Fax:
Practice Address - Street 1:22600 HALL RD STE 201
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48036-1173
Practice Address - Country:US
Practice Address - Phone:586-996-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451019410101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor