Provider Demographics
NPI:1013661123
Name:VALERO-JAROZEWSKI, VICENTA DEL CARMEN (LPCC, LADC)
Entity Type:Individual
Prefix:MS
First Name:VICENTA
Middle Name:DEL CARMEN
Last Name:VALERO-JAROZEWSKI
Suffix:
Gender:F
Credentials:LPCC, LADC
Other - Prefix:MS
Other - First Name:CRISTINA
Other - Middle Name:VICENTA
Other - Last Name:RUUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:871 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2506
Mailing Address - Country:US
Mailing Address - Phone:651-252-1175
Mailing Address - Fax:855-202-4001
Practice Address - Street 1:871 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2506
Practice Address - Country:US
Practice Address - Phone:651-252-1175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN305601101YA0400X
MNCC03180101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)