Provider Demographics
NPI:1235830548
Name:VENTURA, HEATHER (LSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:VENTURA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 BEAVER DR
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9396
Mailing Address - Country:US
Mailing Address - Phone:304-784-3961
Mailing Address - Fax:
Practice Address - Street 1:824 CROSS LANES DR
Practice Address - Street 2:
Practice Address - City:CROSS LANES
Practice Address - State:WV
Practice Address - Zip Code:25313-1338
Practice Address - Country:US
Practice Address - Phone:304-784-3961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSW082216329104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker