Provider Demographics
NPI:1578016721
Name:VALENTE, KELLY (MFT, LCADC-INTERN)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:VALENTE
Suffix:
Gender:F
Credentials:MFT, LCADC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 112
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:NV
Mailing Address - Zip Code:89444-0112
Mailing Address - Country:US
Mailing Address - Phone:775-309-1004
Mailing Address - Fax:
Practice Address - Street 1:1650 US HIGHWAY 395 N STE 101A
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-4331
Practice Address - Country:US
Practice Address - Phone:775-309-1004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-24
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3354106H00000X
NV02203-I101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)