Provider Demographics
NPI:1356390165
Name:VALLIERE & COUNSELING ASSOCIATES, INC
Entity type:Organization
Organization Name:VALLIERE & COUNSELING ASSOCIATES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VERONIQUE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:VALLIERE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:610-530-8392
Mailing Address - Street 1:726 CHURCH ST
Mailing Address - Street 2:P.O. BOX 864
Mailing Address - City:FOGELSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18051-1603
Mailing Address - Country:US
Mailing Address - Phone:610-530-8392
Mailing Address - Fax:610-530-8940
Practice Address - Street 1:726 CHURCH ST
Practice Address - Street 2:
Practice Address - City:FOGELSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18051-1603
Practice Address - Country:US
Practice Address - Phone:610-530-8392
Practice Address - Fax:610-530-8940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007952L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01929559Medicaid
PA01929559Medicaid