Provider Demographics
NPI:1912174822
Name:VON DRAN, VALENCIA SUE (LPC, LCAS)
Entity Type:Individual
Prefix:MS
First Name:VALENCIA
Middle Name:SUE
Last Name:VON DRAN
Suffix:
Gender:F
Credentials:LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 TURNERSBURG HWY
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-2798
Mailing Address - Country:US
Mailing Address - Phone:704-873-1114
Mailing Address - Fax:704-873-8626
Practice Address - Street 1:318 TURNERSBURG HWY
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-2798
Practice Address - Country:US
Practice Address - Phone:704-873-1114
Practice Address - Fax:704-873-8626
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7051101YP2500X
NC2005101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103994Medicaid