Provider Demographics
NPI:1891400719
Name:VALENTINE, KENNETH F (MBA, MA, LPCC, NCC)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:F
Last Name:VALENTINE
Suffix:
Gender:M
Credentials:MBA, MA, LPCC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 ASPEN VILLAGE LOOP
Mailing Address - Street 2:
Mailing Address - City:FRUITA
Mailing Address - State:CO
Mailing Address - Zip Code:81521-8917
Mailing Address - Country:US
Mailing Address - Phone:303-885-7028
Mailing Address - Fax:
Practice Address - Street 1:743 HORIZON CT STE 220
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-8716
Practice Address - Country:US
Practice Address - Phone:844-787-8721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0019604101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health