Provider Demographics
NPI:1154836013
Name:KARINA VALLE, LCSW INC.
Entity Type:Organization
Organization Name:KARINA VALLE, LCSW INC.
Other - Org Name:VALLEY WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:805-614-7272
Mailing Address - Street 1:218 CARMEN LN STE 108
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-7773
Mailing Address - Country:US
Mailing Address - Phone:805-614-7272
Mailing Address - Fax:805-614-7273
Practice Address - Street 1:218 CARMEN LN STE 108
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-7773
Practice Address - Country:US
Practice Address - Phone:805-614-7272
Practice Address - Fax:805-614-7273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty