Provider Demographics
NPI:1740716463
Name:VALENCIA, MARIA D (LPC, LCDC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:D
Last Name:VALENCIA
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12276 TIERRA CANADA DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-4709
Mailing Address - Country:US
Mailing Address - Phone:915-407-4331
Mailing Address - Fax:
Practice Address - Street 1:1390 GEORGE DIETER DR STE 140
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7430
Practice Address - Country:US
Practice Address - Phone:915-320-1390
Practice Address - Fax:915-857-5182
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12218101YA0400X
TX80889101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)