Provider Demographics
NPI:1659317782
Name:PAGES, VANESSA L (PSYD)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:L
Last Name:PAGES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9375 FONTAINEBLEAU BLVD APT L119
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4621
Mailing Address - Country:US
Mailing Address - Phone:305-456-1775
Mailing Address - Fax:786-703-9266
Practice Address - Street 1:9375 FONTAINEBLEAU BLVD APT L119
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4621
Practice Address - Country:US
Practice Address - Phone:305-889-8015
Practice Address - Fax:786-703-9266
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
FLPY 6595103TC0700X
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ0155ZMedicare ID - Type Unspecified