Provider Demographics
NPI:1255684403
Name:STANSBERRY, VALERIE TENILLE (MS, LPC, CRC)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:TENILLE
Last Name:STANSBERRY
Suffix:
Gender:F
Credentials:MS, LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 BEECHURST AVE STE 14B
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-4689
Mailing Address - Country:US
Mailing Address - Phone:304-291-9491
Mailing Address - Fax:
Practice Address - Street 1:709 BEECHURST AVE STE 9B
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-4689
Practice Address - Country:US
Practice Address - Phone:304-290-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2054101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1235598079OtherGROUP NPI