Healthcare Provider Details

I. General information

NPI: 1992854889
Provider Name (Legal Business Name): KATHLEEN WESTGATE VENA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 PURCHASE ST
NEW BEDFORD MA
02740-6260
US

IV. Provider business mailing address

14 SPENCER ST
NEW BEDFORD MA
02740-6738
US

V. Phone/Fax

Practice location:
  • Phone: 508-992-1500
  • Fax: 508-994-0745
Mailing address:
  • Phone: 508-992-4482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: