Provider Demographics
NPI:1528567302
Name:DAVALOS, VALENTINA (LPC-A)
Entity Type:Individual
Prefix:
First Name:VALENTINA
Middle Name:
Last Name:DAVALOS
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8509 THOMPSON TEAL TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78744-4774
Mailing Address - Country:US
Mailing Address - Phone:682-717-9090
Mailing Address - Fax:
Practice Address - Street 1:8509 THOMPSON TEAL TRL
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78744-4774
Practice Address - Country:US
Practice Address - Phone:682-717-9090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-07
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
TX941999101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician