Basic Information
| Provider Information | |||||||||
| NPI: | 1548605306 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VENTURA GOLDMAN | ||||||||
| FirstName: | BIANCA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | VENTURA | ||||||||
| OtherFirstName: | BIANCA | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 58 PAMELA RD | ||||||||
| Address2: | |||||||||
| City: | CORTLANDT MANOR | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105677118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147377338 | ||||||||
| FaxNumber: | 9147371050 | ||||||||
| Practice Location | |||||||||
| Address1: | 1101 MAIN ST | ||||||||
| Address2: | C/O WJCS | ||||||||
| City: | PEEKSKILL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105662907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147377338 | ||||||||
| FaxNumber: | 9147371050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2013 | ||||||||
| LastUpdateDate: | 10/02/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 080075 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.