Provider Demographics
NPI:1578868469
Name:VENEGAS, LUCIA (LPC)
Entity Type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:VENEGAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 W HEMINGWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-1763
Mailing Address - Country:US
Mailing Address - Phone:208-453-8915
Mailing Address - Fax:
Practice Address - Street 1:1009 W HEMINGWAY BLVD
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-1763
Practice Address - Country:US
Practice Address - Phone:208-453-8915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-4581101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health