Provider Demographics
NPI:1750859138
Name:MAXEY, VALERIE (LCSW)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:MAXEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:DUNHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:320 LANIER AVE W STE 200
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7443
Mailing Address - Country:US
Mailing Address - Phone:404-421-7030
Mailing Address - Fax:
Practice Address - Street 1:320 LANIER AVE W STE 200
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7443
Practice Address - Country:US
Practice Address - Phone:404-421-7030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0150001041C0700X
GACSW0082171041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACSW008217OtherGA SECRETARY OF STATE