Provider Demographics
NPI:1316981095
Name:MASTERS, VENUS H (LMHC)
Entity type:Individual
Prefix:
First Name:VENUS
Middle Name:H
Last Name:MASTERS
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:PO BOX 205
Mailing Address - Street 2:
Mailing Address - City:SILVER CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98585-0205
Mailing Address - Country:US
Mailing Address - Phone:360-880-7233
Mailing Address - Fax:
Practice Address - Street 1:1034 S MARKET BLVD
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-3426
Practice Address - Country:US
Practice Address - Phone:360-880-7233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009018101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health