Provider Demographics
NPI:1417256298
Name:MATY, VALERIE ANNE (LPC, CADC)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:ANNE
Last Name:MATY
Suffix:
Gender:F
Credentials:LPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 PUTNAM DR
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-3723
Mailing Address - Country:US
Mailing Address - Phone:630-863-8971
Mailing Address - Fax:
Practice Address - Street 1:1009 PUTNAM DR
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441-3723
Practice Address - Country:US
Practice Address - Phone:630-863-8971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-20
Last Update Date:2011-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL27167101YA0400X
IL178.006154101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)