Provider Demographics
NPI:1639545064
Name:TICHY, VALERIE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:
Last Name:TICHY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 E STATE ST
Mailing Address - Street 2:SUITE 613
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-3300
Mailing Address - Country:US
Mailing Address - Phone:641-421-2089
Mailing Address - Fax:
Practice Address - Street 1:103 E STATE ST
Practice Address - Street 2:SUITE 613
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-3300
Practice Address - Country:US
Practice Address - Phone:641-421-2089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001620101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health