Provider Demographics
NPI:1790899797
Name:VALENTINE, RONALD J (PHD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:J
Last Name:VALENTINE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 921
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-0921
Mailing Address - Country:US
Mailing Address - Phone:919-779-3188
Mailing Address - Fax:919-779-4223
Practice Address - Street 1:1201 AVERSBORO RD
Practice Address - Street 2:SUITE C
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-0921
Practice Address - Country:US
Practice Address - Phone:919-779-3188
Practice Address - Fax:919-779-4223
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC1118103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6172035OtherUBH
7080073OtherAETNA BEHAVIORAL HEALTH
1049234OtherCIGNA BEHAVORIAL HEALTH
5613254570002OtherCIGNA PPO
037018OtherVALUE OPTIONS
93981OtherMEDCOST
NC04815OtherBCBS
7080073OtherAETNA BEHAVIORAL HEALTH