Healthcare Provider Details

I. General information

NPI: 1164588984
Provider Name (Legal Business Name): VANESSA LOUISE CASAVANT MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VANESSA LOUISE MERCHANT

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 LIBBEY INDUSTRIAL PKWY 2ND FLOOR
WEYMOUTH MA
02189-3101
US

IV. Provider business mailing address

169 LIBBEY INDUSTRIAL PKWY 2ND FLOOR
WEYMOUTH MA
02189-3101
US

V. Phone/Fax

Practice location:
  • Phone: 781-551-0999
  • Fax: 781-551-3396
Mailing address:
  • Phone: 781-551-0999
  • Fax: 781-551-3396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number9977
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: