Provider Demographics
NPI:1972859932
Name:GIFFORD, VALERIE M (LCSW)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:M
Last Name:GIFFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 750114
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99775-0114
Mailing Address - Country:US
Mailing Address - Phone:907-328-2944
Mailing Address - Fax:907-328-2944
Practice Address - Street 1:3504 INDUSTRIAL AVE RM 201
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-7390
Practice Address - Country:US
Practice Address - Phone:907-328-2944
Practice Address - Fax:907-328-2944
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPSYP679103TC0700X
AK11251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical