Provider Demographics
NPI:1821348632
Name:VALLEY, CATHERINE (LMSW)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:VALLEY
Suffix:
Gender:F
Credentials:LMSW
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 9541
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-0026
Mailing Address - Country:US
Mailing Address - Phone:479-354-2074
Mailing Address - Fax:479-935-3180
Practice Address - Street 1:54 W SUNBRIDGE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-1822
Practice Address - Country:US
Practice Address - Phone:479-435-4207
Practice Address - Fax:479-935-3180
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
AR7307-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor