Provider Demographics
NPI:1982775201
Name:VENART, ELLEN ELIZABETH (MED, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:ELIZABETH
Last Name:VENART
Suffix:
Gender:F
Credentials:MED, LPC, NCC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:VENART
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1566 DAWS RD
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3607
Mailing Address - Country:US
Mailing Address - Phone:215-542-5004
Mailing Address - Fax:
Practice Address - Street 1:602 S BETHLEHEM PIKE
Practice Address - Street 2:BUILDING B
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-5800
Practice Address - Country:US
Practice Address - Phone:215-542-5004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002790101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional