Active NPI
Georgette Ventura, M.S.
- Clinical Psychologist
- Lebanon, PA
National Provider Identifier
1578645974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS-OO6312-L
- Practice address
- 511 Noble St
Lebanon, PA 17042-6322 - Phone
- (717) 270-8844
- Fax
- (717) 202-2612
- NPI assigned
- Oct 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS-OO6312-L | PA | Primary |
Addresses
Primary practice location
511 Noble St
Lebanon, PA 17042-6322
Mailing address
511 Noble St
Lebanon, PA 17042-6322
Phone (717) 270-8844
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS-OO6312-L | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468972800000",
"number": "1578645974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 NOBLE ST",
"city": "LEBANON",
"state": "PA",
"postal_code": "170426322",
"telephone_number": "717-270-8844",
"fax_number": "717-202-2612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 NOBLE ST",
"city": "LEBANON",
"state": "PA",
"postal_code": "170426322",
"telephone_number": "717-270-8844",
"fax_number": "717-202-2612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENTURA",
"first_name": "GEORGETTE",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-19",
"last_updated": "2016-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS-OO6312-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.