Provider Demographics
NPI:1598190746
Name:CASTER, VALJEANNE ROSS (LMHC MAC, MBA)
Entity Type:Individual
Prefix:MS
First Name:VALJEANNE
Middle Name:ROSS
Last Name:CASTER
Suffix:
Gender:F
Credentials:LMHC MAC, MBA
Other - Prefix:MS
Other - First Name:VALJEANNE
Other - Middle Name:PATRICE
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:931 CASSAT AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-4857
Mailing Address - Country:US
Mailing Address - Phone:904-233-1019
Mailing Address - Fax:
Practice Address - Street 1:931 CASSAT AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205
Practice Address - Country:US
Practice Address - Phone:904-233-1019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL222Q00000X
FLMH14414101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist