Provider Demographics
NPI:1740370113
Name:FREEMAN-VALERIO, CYNTHIA R (LPC)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:R
Last Name:FREEMAN-VALERIO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:R
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 431
Mailing Address - Street 2:
Mailing Address - City:RANCHOS DE TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87557-0431
Mailing Address - Country:US
Mailing Address - Phone:505-770-7658
Mailing Address - Fax:
Practice Address - Street 1:413 SIPAPU ROAD
Practice Address - Street 2:BOX 6952
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571
Practice Address - Country:US
Practice Address - Phone:505-758-5857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2095101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health