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General NPI Number Information
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NPI Number | 1316675291
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Entity Type | Individual
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Provider Name | MARY KATHERINE VENEGAS LMHC
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Gender | Female
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Dates
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Enumeration Date | 08/09/2022
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Last Update Date | 08/09/2022
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Provider Practice Location Address
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Address Line | 308 TEQUESTA DR STE 1
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City | TEQUESTA
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State | FL
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Zip | 33469-3049
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Country | US
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Telephone | 561-972-1604
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1190
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City | JUPITER
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State | FL
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Zip | 33468-1190
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Country | US
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Telephone | 561-972-1604
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH18274
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License Number State | FL
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