MEDICARE: JENNY T. VENTURA M.ED

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	101YP2500X	Professional Counselor	398268	MA
2	305R00000X	Preferred Provider Organization

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	811014109	OTHER	MA	MIND AND BODY BEHAVIORAL HEALTH CENTER, LLC

General Provider Information

NPI Number	:	1871765214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNY T. VENTURA M.ED

Provider Business Mailing Address
First Line	:	PO BOX 482
Second Line	:
City	:	SOUTH EASTON
State	:	MA
Zip	:	02375-0482
Country	:	US
Telephone Number	:	508-243-9331
Fax Number	:

Provider Business Practice Location Address
First Line	:	532 PAGE ST
Second Line	:
City	:	STOUGHTON
State	:	MA
Zip	:	02072-6003
Country	:	US
Telephone Number	:	508-468-7218
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2008
Last Update Date	:	04/13/2025

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