Provider Demographics
NPI:1942241013
Name:GARDNER, VALARIE TUCKER (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:VALARIE
Middle Name:TUCKER
Last Name:GARDNER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 CLATTER AVE
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-4632
Mailing Address - Country:US
Mailing Address - Phone:919-562-7747
Mailing Address - Fax:919-570-9225
Practice Address - Street 1:833 DURHAM RD
Practice Address - Street 2:SUITE A
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-8793
Practice Address - Country:US
Practice Address - Phone:919-570-3004
Practice Address - Fax:919-570-9225
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical