Provider Demographics
NPI:1326502436
Name:CHURCH-WILLIAMS, VALENCIA (EDD, LBA, QBA CAS)
Entity Type:Individual
Prefix:DR
First Name:VALENCIA
Middle Name:
Last Name:CHURCH-WILLIAMS
Suffix:
Gender:F
Credentials:EDD, LBA, QBA CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3790 GUESS RD STE 102
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-6916
Mailing Address - Country:US
Mailing Address - Phone:919-491-8611
Mailing Address - Fax:919-937-2046
Practice Address - Street 1:3790 GUESS RD STE 102
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-6916
Practice Address - Country:US
Practice Address - Phone:919-491-8611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
10771103K00000X
CA11459103K00000X
VA0133002469103K00000X
CA10771106E00000X
106S00000X
NC1115103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1115OtherNC LICENSED BEHAVIOR ANALYST
10771OtherQUALIFIED APPLIED BEHAVIOR ANALYSIS CREDENTIALING BOARD (QABA)