Provider Demographics
NPI:1073266151
Name:VENETIS, KARI ANN (LMSW)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:ANN
Last Name:VENETIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 W CORBETT RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549-1923
Mailing Address - Country:US
Mailing Address - Phone:845-800-8002
Mailing Address - Fax:
Practice Address - Street 1:3 W CORBETT RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549-1923
Practice Address - Country:US
Practice Address - Phone:845-800-8002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-30
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY093899104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker