Provider Demographics
NPI:1376795690
Name:PETERSON, VALERIE P (LMHC, NCC, CCMHC)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:P
Last Name:PETERSON
Suffix:
Gender:F
Credentials:LMHC, NCC, CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 MOUNTAIN DR #106
Mailing Address - Street 2:EMERALD COAST COUNSELING CENTER, P.A.
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541
Mailing Address - Country:US
Mailing Address - Phone:850-837-9100
Mailing Address - Fax:850-837-3774
Practice Address - Street 1:215 MOUNTAIN DR #106
Practice Address - Street 2:EMERALD COAST COUNSELING CENTER, PA
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541
Practice Address - Country:US
Practice Address - Phone:850-837-9100
Practice Address - Fax:850-837-3774
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH-8611101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health