Provider Demographics
NPI:1922430818
Name:VALDEZ, JAYME MARISA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:JAYME
Middle Name:MARISA
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 NANTASKET AVE
Mailing Address - Street 2:
Mailing Address - City:HULL
Mailing Address - State:MA
Mailing Address - Zip Code:02045-2556
Mailing Address - Country:US
Mailing Address - Phone:617-657-3167
Mailing Address - Fax:
Practice Address - Street 1:485 NANTASKET AVE
Practice Address - Street 2:
Practice Address - City:HULL
Practice Address - State:MA
Practice Address - Zip Code:02045-2556
Practice Address - Country:US
Practice Address - Phone:617-657-3167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8480101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health