MEDICARE: VENABLE COUNSELING SERVICES LLC - DBA DEVIL DOG COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1457282055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VENABLE COUNSELING SERVICES LLC - DBA DEVIL DOG COUNSELING

Provider Business Mailing Address
First Line	:	178 COURT ST STE 204
Second Line	:
City	:	AUBURN
State	:	ME
Zip	:	04210-6917
Country	:	US
Telephone Number	:	207-576-8496
Fax Number	:	207-888-1920

Provider Business Practice Location Address
First Line	:	178 COURT ST STE 204
Second Line	:
City	:	AUBURN
State	:	ME
Zip	:	04210-6917
Country	:	US
Telephone Number	:	530-746-8018
Fax Number	:	207-888-1920

Authorized Official
Title or Position	:	CEO/CLINICAL DIRECTOR
Name	:	JEFFREY VENABLE
Credential	:	MA - LCPC
Telephone Number	:	207-576-8496

Provider Enumeration Date	:	05/25/2026
Last Update Date	:	05/25/2026

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