Provider Demographics
NPI:1073549218
Name:MECCA-VALENTE, DEBORAH P (PMHNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:P
Last Name:MECCA-VALENTE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 CHERRY LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-1356
Mailing Address - Country:US
Mailing Address - Phone:716-316-5842
Mailing Address - Fax:716-205-0824
Practice Address - Street 1:33 CHERRY LAUREL LN
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-1356
Practice Address - Country:US
Practice Address - Phone:716-316-5842
Practice Address - Fax:716-205-0824
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2020-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY400272101YM0800X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1073549218Medicaid
NY11426BMedicare ID - Type Unspecified