Healthcare Provider Details

I. General information

NPI: 1962792259
Provider Name (Legal Business Name): ABBY J VENZOR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2011
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 STONY BROOK CT
NEWBURGH NY
12550-6519
US

IV. Provider business mailing address

12 GEDNEY WAY
NEWBURGH NY
12550-3738
US

V. Phone/Fax

Practice location:
  • Phone: 914-734-5248
  • Fax:
Mailing address:
  • Phone: 347-693-3347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number080107
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: