Provider Demographics
NPI:1982494001
Name:GARRETT, VANESSA (CPS-MH, IPS)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:GARRETT
Suffix:
Gender:F
Credentials:CPS-MH, IPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1544 WELLBORN RD UNIT 312
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30074-1501
Mailing Address - Country:US
Mailing Address - Phone:943-213-0870
Mailing Address - Fax:
Practice Address - Street 1:1544 WELLBORN RD UNIT 312
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30074-1501
Practice Address - Country:US
Practice Address - Phone:943-213-0870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist