Provider Demographics
NPI:1295400810
Name:VENETZ, ABIGAIL (LCPC)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:VENETZ
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-3705
Mailing Address - Country:US
Mailing Address - Phone:406-761-2100
Mailing Address - Fax:406-761-2107
Practice Address - Street 1:1900 2ND AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-2704
Practice Address - Country:US
Practice Address - Phone:406-268-6385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT48501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health