Provider Demographics
NPI:1265100028
Name:VALIENTE PSYCHOTHERAPY SERVICES
Entity type:Organization
Organization Name:VALIENTE PSYCHOTHERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:718-812-7169
Mailing Address - Street 1:461 DEAN ST APT 22K
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-4156
Mailing Address - Country:US
Mailing Address - Phone:718-812-7169
Mailing Address - Fax:718-732-2572
Practice Address - Street 1:461 DEAN ST APT 22K
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-4156
Practice Address - Country:US
Practice Address - Phone:718-812-7169
Practice Address - Fax:718-732-2572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-05
Last Update Date:2021-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)