Provider Demographics
NPI:1548605306
Name:VENTURA GOLDMAN, BIANCA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BIANCA
Middle Name:
Last Name:VENTURA GOLDMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:BIANCA
Other - Middle Name:
Other - Last Name:VENTURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:58 PAMELA RD
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-7118
Mailing Address - Country:US
Mailing Address - Phone:914-737-7338
Mailing Address - Fax:914-737-1050
Practice Address - Street 1:1101 MAIN ST
Practice Address - Street 2:C/O WJCS
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-2907
Practice Address - Country:US
Practice Address - Phone:914-737-7338
Practice Address - Fax:914-737-1050
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080075104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400089307Medicare PIN