Healthcare Provider Details

I. General information

NPI: 1164889218
Provider Name (Legal Business Name): VENUS E. ALLEN LCSWA, LCASA, CCM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2016
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 J.N. PEASE PLACE STE 101
CHARLOTTE NC
28262-4507
US

IV. Provider business mailing address

3515 DAVID COX RD UNIT 480568
CHARLOTTE NC
28269-2492
US

V. Phone/Fax

Practice location:
  • Phone: 919-807-1090
  • Fax: 800-465-8147
Mailing address:
  • Phone: 919-807-1090
  • Fax: 800-465-8147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS-24717
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023608
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: