Provider Demographics
NPI:1134973688
Name:VENEGAS, MILAGROS C (CJC, LCADC, LCSW)
Entity type:Individual
Prefix:
First Name:MILAGROS
Middle Name:C
Last Name:VENEGAS
Suffix:
Gender:F
Credentials:CJC, LCADC, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 447
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08903
Mailing Address - Country:US
Mailing Address - Phone:908-420-5888
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 447
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08903-0447
Practice Address - Country:US
Practice Address - Phone:908-420-5888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC06260000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health