Provider Demographics
NPI:1083456685
Name:VALADARES, PRISCILLA REIS (LMHC QS)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:REIS
Last Name:VALADARES
Suffix:
Gender:F
Credentials:LMHC QS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5616 SW 120TH AVE
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33330-3323
Mailing Address - Country:US
Mailing Address - Phone:954-937-3337
Mailing Address - Fax:
Practice Address - Street 1:5616 SW 120TH AVE
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33330-3323
Practice Address - Country:US
Practice Address - Phone:954-937-3337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14878101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health