Individual
ALEXANDER VENABLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, CADC
Contact information
Practice address
5230 6TH STREET FRONTAGE RD E, SPRINGFIELD, IL 62703-5128
(217) 585-1180
Mailing address
5230 6TH STREET FRONTAGE RD E, SPRINGFIELD, IL 62703-5128
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/12/2018
Last updated
03/17/2018
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