Provider Demographics
NPI:1023256104
Name:ACOSTA, VALERIE DALTON (LPC)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:DALTON
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:CLAIRE
Other - Last Name:DALTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:4990 SADLER PLACE
Mailing Address - Street 2:#3372
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-3372
Mailing Address - Country:US
Mailing Address - Phone:804-396-2585
Mailing Address - Fax:804-270-2090
Practice Address - Street 1:11809 WILLPAGE PL
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-1673
Practice Address - Country:US
Practice Address - Phone:804-396-2585
Practice Address - Fax:804-364-5678
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-28
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003869101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA11914039OtherCAQH