Provider Demographics
NPI:1982215521
Name:VENTO, ISABELLA (MA, LPC, NCC)
Entity type:Individual
Prefix:MS
First Name:ISABELLA
Middle Name:
Last Name:VENTO
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:MRS
Other - First Name:ISABELLA
Other - Middle Name:
Other - Last Name:PARADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2899 E MAGDALENA DR
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-1643
Mailing Address - Country:US
Mailing Address - Phone:602-291-0703
Mailing Address - Fax:
Practice Address - Street 1:4657 S LAKESHORE DR STE 1
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7170
Practice Address - Country:US
Practice Address - Phone:480-718-1261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-16
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-21986101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty