Individual
CECILIA ELLEN VENABLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
135 W 50TH ST, 6TH FLOOR, NEW YORK, NY 10020-1201
(718) 327-7660
(718) 327-4230
Mailing address
331 BEACH 31 STREET, APT 8G, FAR ROCKAWAY, NY 11691
(718) 327-7660
(718) 327-4230
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
NY
Other
Enumeration date
11/02/2011
Last updated
11/02/2011
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