Provider Demographics
NPI:1831603364
Name:HESKETH, VALERIE LYNN KENNEDY (LCPC)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:LYNN KENNEDY
Last Name:HESKETH
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 RIDLEY RD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-6218
Mailing Address - Country:US
Mailing Address - Phone:207-206-0997
Mailing Address - Fax:
Practice Address - Street 1:849 MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-3694
Practice Address - Country:US
Practice Address - Phone:207-358-8546
Practice Address - Fax:207-218-0637
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL4950101YM0800X, 101YP2500X
MECC5562101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health