Healthcare Provider Details

I. General information

NPI: 1609701861
Provider Name (Legal Business Name): VANESSA ISABEL BALLABENI LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 CHAPEL HILL RD STE 23
DURHAM NC
27707-1186
US

IV. Provider business mailing address

902 PARKRIDGE RD APT A5
DURHAM NC
27713-9324
US

V. Phone/Fax

Practice location:
  • Phone: 919-678-7101
  • Fax:
Mailing address:
  • Phone: 919-678-7101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023868
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: