Most Relevant Information
Provider Data
| NPI Number: | 1003246810 |
| Provider Name: | VANESSA BLACK MAED, CSOTP, LPC NCC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 10278 |
Most Important Dates
| Enumeration Date: | 11/14/2013 |
| Last Updated: | 04/09/2016 |
Provider Practice Location
1000 S MAIN ST
SUITE 2
LAURINBURG
NC
283524764
Practice Location Phone/Fax
| Phone: | 9103842175 |
| Fax: | 8778982026 |
Provider Mailing Location
18201 SNEADS GROVE RD
LAURINBURG
NC
283523061
Provider Mailing Phone/Fax
| Phone: | 9103842175 |
| Fax: | 8778982026 |