Provider Demographics
NPI:1801113899
Name:VALES, JAMES ANTHONY SR (LCSW-P)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ANTHONY
Last Name:VALES
Suffix:SR
Gender:M
Credentials:LCSW-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4276 LEGEND AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-1965
Mailing Address - Country:US
Mailing Address - Phone:910-485-6843
Mailing Address - Fax:
Practice Address - Street 1:4276 LEGEND AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-1965
Practice Address - Country:US
Practice Address - Phone:910-485-6843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0053361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical