Provider Demographics
NPI:1760689806
Name:EVERETTE, VANESSA LOUISE
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:LOUISE
Last Name:EVERETTE
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 1:8 JULIAN DR
Mailing Address - Street 2:
Mailing Address - City:PENN HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15235-1726
Mailing Address - Country:US
Mailing Address - Phone:412-675-8533
Mailing Address - Fax:412-675-8920
Practice Address - Street 1:606 LOCUST ST
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-2911
Practice Address - Country:US
Practice Address - Phone:412-675-8533
Practice Address - Fax:412-675-8920
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health