Provider Demographics
NPI:1073862678
Name:AUSTIN, VALERIE (LAPC)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 34TH AVE E APT 103
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-8049
Mailing Address - Country:US
Mailing Address - Phone:701-491-8260
Mailing Address - Fax:
Practice Address - Street 1:875 34TH AVE E APT 103
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-8049
Practice Address - Country:US
Practice Address - Phone:701-491-8260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1075-7-1-20-483101YM0800X
ND1075-7-1-20A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health