Provider Demographics
NPI:1730485145
Name:SMALLWOOD, VALENCIA LETITIA (LPC, CSAC)
Entity Type:Individual
Prefix:MRS
First Name:VALENCIA
Middle Name:LETITIA
Last Name:SMALLWOOD
Suffix:
Gender:F
Credentials:LPC, CSAC
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 37486
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23234-7486
Mailing Address - Country:US
Mailing Address - Phone:804-334-3660
Mailing Address - Fax:804-271-7035
Practice Address - Street 1:6100 MOONLIGHT DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23234-4913
Practice Address - Country:US
Practice Address - Phone:804-334-3660
Practice Address - Fax:804-271-7035
Is Sole Proprietor?:No
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710101783101YA0400X
VA0701004976101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)