Provider Demographics
NPI:1710138904
Name:BUSHWOOD, VALERIE DAVIS (LCSW)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:DAVIS
Last Name:BUSHWOOD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 S. PRICE RD
Mailing Address - Street 2:#122
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-9726
Mailing Address - Country:US
Mailing Address - Phone:480-330-5249
Mailing Address - Fax:480-418-3358
Practice Address - Street 1:3125 S. PRICE RD
Practice Address - Street 2:#122
Practice Address - City:CHANDLER
Practice Address - State:NY
Practice Address - Zip Code:85248-9726
Practice Address - Country:US
Practice Address - Phone:480-330-5249
Practice Address - Fax:480-418-3358
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW26371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical