Provider Demographics
NPI:1871754580
Name:LAYNE, VANESSA (MED, LMHC)
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:
Last Name:LAYNE
Suffix:
Gender:F
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 MASSACHUSETTS AVE
Mailing Address - Street 2:SUITE 135
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-2808
Mailing Address - Country:US
Mailing Address - Phone:617-299-1611
Mailing Address - Fax:617-876-0192
Practice Address - Street 1:61 ROSELAND ST
Practice Address - Street 2:STE 10
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-3524
Practice Address - Country:US
Practice Address - Phone:617-299-1611
Practice Address - Fax:617-876-0192
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA7956101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health