Provider Demographics
NPI:1013530146
Name:VALLEY, MEGAN B (MA, LCMHC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:B
Last Name:VALLEY
Suffix:
Gender:F
Credentials:MA, LCMHC
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 671
Mailing Address - Street 2:
Mailing Address - City:BARTON
Mailing Address - State:VT
Mailing Address - Zip Code:05822-0671
Mailing Address - Country:US
Mailing Address - Phone:802-673-8336
Mailing Address - Fax:
Practice Address - Street 1:21 WATER ST STE 2
Practice Address - Street 2:
Practice Address - City:ORLEANS
Practice Address - State:VT
Practice Address - Zip Code:05860-1324
Practice Address - Country:US
Practice Address - Phone:802-673-8336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-23
Last Update Date:2020-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0134234101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor