MEDICARE: VANESSA VICTORIA THOMAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		FL

General Provider Information

NPI Number	:	1699635128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA VICTORIA THOMAS

Provider Business Mailing Address
First Line	:	508 NW 15TH WAY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-8848
Country	:	US
Telephone Number	:	754-276-8773
Fax Number	:

Provider Business Practice Location Address
First Line	:	508 NW 15TH WAY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-8848
Country	:	US
Telephone Number	:	754-276-8773
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2025
Last Update Date	:	11/17/2025

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Directions to “ VANESSA VICTORIA THOMAS ” Practice Location

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