Provider Demographics
NPI:1023042447
Name:VALENTINE, CLIFF R (LMHC)
Entity Type:Individual
Prefix:
First Name:CLIFF
Middle Name:R
Last Name:VALENTINE
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 ROBERT J CONLAN BLVD NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-3502
Mailing Address - Country:US
Mailing Address - Phone:321-723-8823
Mailing Address - Fax:321-723-9551
Practice Address - Street 1:1501 ROBERT J CONLAN BLVD NE
Practice Address - Street 2:SUITE 200
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-3502
Practice Address - Country:US
Practice Address - Phone:321-723-8823
Practice Address - Fax:321-723-9551
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH142101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health