Provider Demographics
NPI:1518671494
Name:CHARLES EDWARD VALLIER, LLC
Entity Type:Organization
Organization Name:CHARLES EDWARD VALLIER, LLC
Other - Org Name:AGAPE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:VALLIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-939-1030
Mailing Address - Street 1:2920 9TH ST N
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77590-4238
Mailing Address - Country:US
Mailing Address - Phone:409-939-1030
Mailing Address - Fax:
Practice Address - Street 1:5718 WESTHEIMER RD STE 1000
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-9903
Practice Address - Country:US
Practice Address - Phone:282-767-9303
Practice Address - Fax:409-655-5490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-05
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health