Individual provider Active NPI

Vanessa Venable, PHD

  • Clinical Psychologist
  • Butner, NC
National Provider Identifier
1982629465
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3085 Issued in NC
Practice address
300 Veazey Dr
Butner, NC 27509-1668
Phone
(919) 764-5827
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3085 NC Primary

Addresses

Primary practice location

300 Veazey Dr
Butner, NC 27509-1668

Mailing address

300 Veazey Dr
Butner, NC 27509-1668
Phone (919) 764-5827

Other identifiers 1

IdentifierTypeStateIssuer
6000692MedicaidNC

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3085NCMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1982629465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 VEAZEY DR",
            "city": "BUTNER",
            "state": "NC",
            "postal_code": "275091668",
            "telephone_number": "919-764-5827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 VEAZEY DR",
            "city": "BUTNER",
            "state": "NC",
            "postal_code": "275091668",
            "telephone_number": "919-764-5827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENABLE",
        "first_name": "VANESSA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000692",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Butner, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; 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.