Provider Demographics
NPI:1013966084
Name:VALENZUELA, BETHYE ANN (LPC, MAC)
Entity Type:Individual
Prefix:
First Name:BETHYE
Middle Name:ANN
Last Name:VALENZUELA
Suffix:
Gender:F
Credentials:LPC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 DEWITT LOOP
Mailing Address - Street 2:
Mailing Address - City:FORT BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060-5285
Mailing Address - Country:US
Mailing Address - Phone:703-597-1562
Mailing Address - Fax:571-231-1374
Practice Address - Street 1:9300 DEWITT LOOP
Practice Address - Street 2:WARRIOR PAVILION
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-5285
Practice Address - Country:US
Practice Address - Phone:703-597-1562
Practice Address - Fax:703-805-0049
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004133101YP2500X
VA014427101YA0400X
MO2001029224101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional