Provider Demographics
NPI:1932705035
Name:VALDES, JAMES (RMHCI, NCC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:VALDES
Suffix:
Gender:M
Credentials:RMHCI, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 W KENTUCKY AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-4644
Mailing Address - Country:US
Mailing Address - Phone:813-644-2039
Mailing Address - Fax:
Practice Address - Street 1:703 W KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-4644
Practice Address - Country:US
Practice Address - Phone:813-360-1821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-05
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH19143101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health