Provider Demographics
NPI:1356037246
Name:VALLEY COUNSELING & CLINICAL PSYCHOLOGY INC
Entity type:Organization
Organization Name:VALLEY COUNSELING & CLINICAL PSYCHOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMER
Authorized Official - Middle Name:
Authorized Official - Last Name:FAWZY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPCC
Authorized Official - Phone:612-719-1680
Mailing Address - Street 1:5200 WILLSON RD STE 1505027
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55424-1332
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5200 WILLSON RD STE 1505027
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55424-1332
Practice Address - Country:US
Practice Address - Phone:612-719-1680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-13
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty