Healthcare Provider Details

I. General information

NPI: 1871765214
Provider Name (Legal Business Name): JENNY T. VENTURA M.ED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2008
Last Update Date: 04/13/2025
Certification Date: 04/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 PAGE ST
STOUGHTON MA
02072-6003
US

IV. Provider business mailing address

PO BOX 482
SOUTH EASTON MA
02375-0482
US

V. Phone/Fax

Practice location:
  • Phone: 508-468-7218
  • Fax:
Mailing address:
  • Phone: 508-243-9331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number398268
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: