Michelle R Venturi, LCSW CADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149 012958 Issued in IL

Practice address

4230 Lincolnshire Dr Ste D
Mount Vernon, IL 62864-2189

Phone

(618) 242-4205

Fax

(618) 242-4209

NPI assigned

Jun 27, 2008

Last updated

Jun 27, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1760644017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 LINCOLNSHIRE DR STE D",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642189",
            "telephone_number": "618-242-4205",
            "fax_number": "618-242-4209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 LINCOLNSHIRE DR STE D",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642189",
            "telephone_number": "618-242-4205",
            "fax_number": "618-242-4209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTURI",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "credential": "LCSW CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-27",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "25196",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149 012958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.