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Individual

MISS JANE B VENABLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, CSAC

Contact information

Practice address
1720 MILLBROOK ST, SALEM, VA 24153-4210
(540) 815-4355
Mailing address
1720 MILLBROOK ST, SALEM, VA 24153-4210
(540) 815-4355

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
0904005297
VA
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710000841
VA
1041C0700X
Clinical Social Worker
Primary
0904005297
VA
1041C0700X
Clinical Social Worker
C006755
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004945263
VA
01
802183000
LCSW
VI
Enumeration date
03/21/2006
Last updated
12/22/2011
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