Healthcare Provider Details

I. General information

NPI: 1578616488
Provider Name (Legal Business Name): DORIS VENETTA OBENSHAIN MS, NCC, CADC, LPCMH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 02/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 POLLY DRUMMOND HILL RD
NEWARK DE
19711-4342
US

IV. Provider business mailing address

PO BOX 577
CECILTON MD
21913-0577
US

V. Phone/Fax

Practice location:
  • Phone: 302-448-1450
  • Fax:
Mailing address:
  • Phone: 410-275-8094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC0000442
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: