Provider Demographics
NPI:1053601377
Name:RISOVIC-DROMSKY, VANESSA (LICSW)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:RISOVIC-DROMSKY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 WASHINGTON AVE
Mailing Address - Street 2:15
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-3655
Mailing Address - Country:US
Mailing Address - Phone:617-602-0199
Mailing Address - Fax:
Practice Address - Street 1:20 WHEELER ST
Practice Address - Street 2:4TH- BCCRD
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-4416
Practice Address - Country:US
Practice Address - Phone:781-593-0100
Practice Address - Fax:781-599-3329
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1160421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical