Healthcare Provider Details

I. General information

NPI: 1639055676
Provider Name (Legal Business Name): VANESSA DAMELINES-OBREGON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 SEBER RD BLDG 5
HACKETTSTOWN NJ
07840-1722
US

IV. Provider business mailing address

117 SEBER RD BLDG 5
HACKETTSTOWN NJ
07840-1722
US

V. Phone/Fax

Practice location:
  • Phone: 908-452-5366
  • Fax:
Mailing address:
  • Phone: 908-452-5366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06532300
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: