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General NPI Number Information
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NPI Number | 1891391785
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Entity Type | Individual
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Provider Name | VANESSA NICOLE COUSENES SW23781
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Gender | Female
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Dates
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Enumeration Date | 12/07/2020
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 3155 LAKE WORTH RD STE 1
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City | PALM SPRINGS
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State | FL
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Zip | 33461-6917
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Country | US
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Telephone | 561-398-5826
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Fax |
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Provider Business Mailing Address
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Address Line | 806 HAMPTON RD
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City | WEST PALM BEACH
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State | FL
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Zip | 33405-1428
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Country | US
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Telephone | 650-814-8130
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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 | SW23781
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License Number State | FL
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