Provider Demographics
NPI:1396914107
Name:ELIZABETH VENART LLC
Entity type:Organization
Organization Name:ELIZABETH VENART LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:VENART
Authorized Official - Suffix:
Authorized Official - Credentials:MED, NCC, LPC
Authorized Official - Phone:215-542-5004
Mailing Address - Street 1:1566 DAWS RD
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3607
Mailing Address - Country:US
Mailing Address - Phone:215-542-5004
Mailing Address - Fax:
Practice Address - Street 1:602 S BETHLEHEM PIKE
Practice Address - Street 2:BUILDING B
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-5800
Practice Address - Country:US
Practice Address - Phone:215-542-5004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002790101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty