Provider Demographics
NPI:1023600558
Name:VANESSA DVORIN-FREMONT
Entity type:Organization
Organization Name:VANESSA DVORIN-FREMONT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DVORIN-FREMONT
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MSSA, LISW-S
Authorized Official - Phone:216-570-6353
Mailing Address - Street 1:4502 GROVELAND RD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3923
Mailing Address - Country:US
Mailing Address - Phone:216-570-6353
Mailing Address - Fax:
Practice Address - Street 1:4502 GROVELAND RD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-3923
Practice Address - Country:US
Practice Address - Phone:216-570-6353
Practice Address - Fax:216-297-9522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-05
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty