Healthcare Provider Details

I. General information

NPI: 1073189122
Provider Name (Legal Business Name): VICTORIA VENO LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2021
Last Update Date: 05/30/2021
Certification Date: 05/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 N UNION ST
OLEAN NY
14760-2736
US

IV. Provider business mailing address

1220 QUEEN ST
OLEAN NY
14760-3063
US

V. Phone/Fax

Practice location:
  • Phone: 716-375-7500
  • Fax:
Mailing address:
  • Phone: 716-373-3339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number000215
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: