Provider Demographics
NPI:1497590061
Name:WALBURN, VALERIE MAE (LSW)
Entity type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:MAE
Last Name:WALBURN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07401-1113
Mailing Address - Country:US
Mailing Address - Phone:201-264-4058
Mailing Address - Fax:
Practice Address - Street 1:584 STATE RT 17 NORTH
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-2000
Practice Address - Country:US
Practice Address - Phone:201-556-8210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07120900104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker