Provider Demographics
NPI:1982497202
Name:MACIAS-JENNY, VANIA HANNALI
Entity type:Individual
Prefix:MS
First Name:VANIA
Middle Name:HANNALI
Last Name:MACIAS-JENNY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VANIA
Other - Middle Name:HANNALI
Other - Last Name:MACIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3129 SHADOW DUSK AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3116
Mailing Address - Country:US
Mailing Address - Phone:314-808-7956
Mailing Address - Fax:
Practice Address - Street 1:2520 SAINT ROSE PKWY STE 310
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7790
Practice Address - Country:US
Practice Address - Phone:702-495-6562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical