Provider Demographics
NPI:1447353073
Name:VENUS, JANET CLARE (PHD)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:CLARE
Last Name:VENUS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 GLENDALE ROAD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-4047
Mailing Address - Country:US
Mailing Address - Phone:434-284-3478
Mailing Address - Fax:434-978-0118
Practice Address - Street 1:690 BERKMAR CIRCLE
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901
Practice Address - Country:US
Practice Address - Phone:434-284-3478
Practice Address - Fax:434-978-0118
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNR68453163W00000X
VA0810006113103TC0700X
NJS103433103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No163W00000XNursing Service ProvidersRegistered Nurse
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ023318Medicare ID - Type Unspecified