Provider Demographics
NPI:1306003116
Name:VALENTINE-BLOUNT, KATHERINE N
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:N
Last Name:VALENTINE-BLOUNT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 JACK BRANCH RD # 2A
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:NC
Mailing Address - Zip Code:27983-7406
Mailing Address - Country:US
Mailing Address - Phone:252-287-0213
Mailing Address - Fax:252-287-0213
Practice Address - Street 1:348 JACK BRANCH RD # 2A
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NC
Practice Address - Zip Code:27983-7406
Practice Address - Country:US
Practice Address - Phone:252-287-0213
Practice Address - Fax:252-287-0213
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No171W00000XOther Service ProvidersContractor
No175T00000XOther Service ProvidersPeer Specialist
No291U00000XLaboratoriesClinical Medical Laboratory