Provider Demographics
NPI:1821280249
Name:VENABLE, DANA HUNTER SIBLEY (LMHC, ATR)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:HUNTER SIBLEY
Last Name:VENABLE
Suffix:
Gender:F
Credentials:LMHC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 MOUNT VERNON PARK
Mailing Address - Street 2:APT #1
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-2814
Mailing Address - Country:US
Mailing Address - Phone:617-304-1678
Mailing Address - Fax:
Practice Address - Street 1:7 LINCOLN ST
Practice Address - Street 2:SUITE# 311
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-3021
Practice Address - Country:US
Practice Address - Phone:617-304-1678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7535101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health