Provider Demographics
NPI:1669240909
Name:VERONICA VALENZUELA COUNSELING, LLC
Entity type:Organization
Organization Name:VERONICA VALENZUELA COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:A
Authorized Official - Last Name:VALENZUELA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:503-705-5325
Mailing Address - Street 1:6204 SE WINDSOR CT
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-1365
Mailing Address - Country:US
Mailing Address - Phone:503-705-5325
Mailing Address - Fax:
Practice Address - Street 1:314 NE 19TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2829
Practice Address - Country:US
Practice Address - Phone:503-705-5325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty