Provider Demographics
NPI:1770208969
Name:GORDON-GAROFALO, VALERIE L (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:L
Last Name:GORDON-GAROFALO
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80799 OGDEN RD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70435-8381
Mailing Address - Country:US
Mailing Address - Phone:504-939-7308
Mailing Address - Fax:
Practice Address - Street 1:80799 OGDEN RD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70435-8381
Practice Address - Country:US
Practice Address - Phone:504-939-7308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA74901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical