Provider Demographics
NPI:1376929331
Name:VENTURA, HENRY (MHC)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:
Last Name:VENTURA
Suffix:
Gender:M
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9430 60TH AVE APT 5J
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-5083
Mailing Address - Country:US
Mailing Address - Phone:347-684-7052
Mailing Address - Fax:
Practice Address - Street 1:2626 75TH ST
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370-1427
Practice Address - Country:US
Practice Address - Phone:718-350-3110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health