Provider Demographics
NPI:1639685282
Name:WORRELL, VALENCIA (BS CAP, ICADC)
Entity Type:Individual
Prefix:MRS
First Name:VALENCIA
Middle Name:
Last Name:WORRELL
Suffix:
Gender:F
Credentials:BS CAP, ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 NW FRIAR ST
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-1564
Mailing Address - Country:US
Mailing Address - Phone:561-352-3128
Mailing Address - Fax:
Practice Address - Street 1:1302 N LSWNWOOD CR
Practice Address - Street 2:SUITE B
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950
Practice Address - Country:US
Practice Address - Phone:772-468-6800
Practice Address - Fax:772-464-3800
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)