Provider Demographics
NPI:1285943639
Name:VENEGAS, PATRICIA (LMHC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:VENEGAS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STURBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01566-1540
Mailing Address - Country:US
Mailing Address - Phone:508-418-6888
Mailing Address - Fax:508-418-6886
Practice Address - Street 1:258 MAIN ST
Practice Address - Street 2:
Practice Address - City:STURBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01566-1540
Practice Address - Country:US
Practice Address - Phone:508-418-6888
Practice Address - Fax:508-418-6886
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC11174101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health