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General NPI Number Information
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NPI Number | 1447143029
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Entity Type | Individual
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Provider Name | VANESSA MARIE SAUCEDO LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 310 N UNIVERSITY DR
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City | NACOGDOCHES
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State | TX
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Zip | 75961-5123
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Country | US
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Telephone | 936-272-0555
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Fax |
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Provider Business Mailing Address
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Address Line | 505 ROSEWOOD CIR
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City | LUFKIN
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State | TX
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Zip | 75901-5716
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Country | US
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Telephone | 936-899-0833
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 69394
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License Number State | TX
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