Provider Demographics
NPI:1609210889
Name:HARVELL, VANESSA LOUISE (MFT)
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:LOUISE
Last Name:HARVELL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 OCEAN PARK BLVD
Mailing Address - Street 2:APT 106
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-4763
Mailing Address - Country:US
Mailing Address - Phone:424-248-9494
Mailing Address - Fax:
Practice Address - Street 1:1128 OCEAN PARK BLVD
Practice Address - Street 2:APT 106
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-4763
Practice Address - Country:US
Practice Address - Phone:424-248-9494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health