Provider Demographics
NPI:1932398617
Name:PERRY, VALERIE DIANE (LCSW)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:DIANE
Last Name:PERRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 SE 28TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4268
Mailing Address - Country:US
Mailing Address - Phone:479-876-8626
Mailing Address - Fax:479-876-8636
Practice Address - Street 1:809 SE 28TH ST STE 1
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-4268
Practice Address - Country:US
Practice Address - Phone:479-876-8626
Practice Address - Fax:479-876-8636
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2021-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-10181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical