Healthcare Provider Details

I. General information

NPI: 1316298292
Provider Name (Legal Business Name): VANESSA MICHELLE HAUGHTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2012
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 MATTEAWAN RD
BEACON NY
12508-1500
US

IV. Provider business mailing address

6339 MILL ST
RHINEBECK NY
12572-1427
US

V. Phone/Fax

Practice location:
  • Phone: 845-838-6900
  • Fax:
Mailing address:
  • Phone: 845-871-1000
  • Fax: 845-516-7800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number090000
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: