Provider Demographics
NPI:1962859330
Name:VALLEY, STEPHEN BARTON (MED, LPC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:BARTON
Last Name:VALLEY
Suffix:
Gender:M
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 1ST ST SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4701
Mailing Address - Country:US
Mailing Address - Phone:540-343-0004
Mailing Address - Fax:
Practice Address - Street 1:1115 1ST ST SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4701
Practice Address - Country:US
Practice Address - Phone:540-343-0004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006589101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional