Provider Demographics
NPI:1740455518
Name:WARUSZEWSKI, VALERIE A (PHD)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:A
Last Name:WARUSZEWSKI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 5TH ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-5920
Mailing Address - Country:US
Mailing Address - Phone:423-822-5099
Mailing Address - Fax:423-822-5099
Practice Address - Street 1:100 5TH ST
Practice Address - Street 2:SUITE 310
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-5920
Practice Address - Country:US
Practice Address - Phone:423-822-5099
Practice Address - Fax:423-822-5099
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2480101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional