Healthcare Provider Details

I. General information

NPI: 1528978731
Provider Name (Legal Business Name): SIDNEY VENERIS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 N COMMERCIAL ST STE 1200100
BELLINGHAM WA
98225-4446
US

IV. Provider business mailing address

100 PROSPECT ST APT 10
BELLINGHAM WA
98225-4425
US

V. Phone/Fax

Practice location:
  • Phone: 360-734-0615
  • Fax:
Mailing address:
  • Phone: 805-722-5981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: