Provider Demographics
NPI:1851813331
Name:WILLEMS, VALORIE
Entity Type:Individual
Prefix:
First Name:VALORIE
Middle Name:
Last Name:WILLEMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 MCGILL AVE NW STE 506
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-6199
Mailing Address - Country:US
Mailing Address - Phone:704-292-6428
Mailing Address - Fax:
Practice Address - Street 1:325 MCGILL AVE NW STE 506
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-6199
Practice Address - Country:US
Practice Address - Phone:704-292-6428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24091101YA0400X
NC2154106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)