Provider Demographics
NPI:1073509816
Name:VENABLE, EUGENA K (LMHC)
Entity Type:Individual
Prefix:
First Name:EUGENA
Middle Name:K
Last Name:VENABLE
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 1:8400 LOUISIANA ST.
Mailing Address - Street 2:
Mailing Address - City:MERILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6385
Mailing Address - Country:US
Mailing Address - Phone:219-757-1928
Mailing Address - Fax:219-757-1950
Practice Address - Street 1:1409 E 84TH PLACE
Practice Address - Street 2:
Practice Address - City:MERILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6451
Practice Address - Country:US
Practice Address - Phone:219-794-2000
Practice Address - Fax:219-794-2010
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000723A101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional