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General NPI Number Information
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NPI Number | 1902296924
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Entity Type | Individual
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Provider Name | GAIL VENERABLE LPC/CADC-II/ICADC
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Gender | Female
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 08/08/2016
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Provider Practice Location Address
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Address Line | 235 E PONCE DE LEON AVE SUITE 305
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City | DECATUR
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State | GA
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Zip | 30030-3452
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Country | US
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Telephone | 770-905-1291
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Fax | 678-668-7222
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Provider Business Mailing Address
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Address Line | 235 E PONCE DE LEON AVE SUITE 305
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City | DECATUR
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State | GA
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Zip | 30030-3452
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Country | US
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Telephone | 770-905-1291
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Fax | 678-668-7222
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CAC-II 1827
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CADC-II 664
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC009133
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License Number State | GA
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