Provider Demographics
NPI:1013642628
Name:ROSS, VALERIE R (LCMHC)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:R
Last Name:ROSS
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2165 W PUMPKIN PATCH LN
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-5345
Mailing Address - Country:US
Mailing Address - Phone:801-318-8440
Mailing Address - Fax:
Practice Address - Street 1:2578 W 600 N STE 102
Practice Address - Street 2:
Practice Address - City:LINDON
Practice Address - State:UT
Practice Address - Zip Code:84042-1260
Practice Address - Country:US
Practice Address - Phone:385-220-0770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT315917-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty