Provider Demographics
NPI:1336613819
Name:CARNEY BREENE, VENETIA ROSE (LICSW)
Entity type:Individual
Prefix:MS
First Name:VENETIA
Middle Name:ROSE
Last Name:CARNEY BREENE
Suffix:
Gender:
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 NEPTUNE ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-4747
Mailing Address - Country:US
Mailing Address - Phone:978-825-6648
Mailing Address - Fax:
Practice Address - Street 1:55 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2185
Practice Address - Country:US
Practice Address - Phone:978-825-6648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-17
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1262001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical