Provider Demographics
NPI:1457528739
Name:WEST VALLEY PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:WEST VALLEY PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:WEST VALLEY FAMILY DEVELOPMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KEMPER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:623-312-3713
Mailing Address - Street 1:13575 WEST INDIAN SCHOOL ROAD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340
Mailing Address - Country:US
Mailing Address - Phone:623-312-3713
Mailing Address - Fax:623-328-9352
Practice Address - Street 1:13575 WEST INDIAN SCHOOL ROAD
Practice Address - Street 2:SUITE 500
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340
Practice Address - Country:US
Practice Address - Phone:623-312-3713
Practice Address - Fax:623-328-9352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3338103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty