Provider Demographics
NPI:1487717369
Name:FANE, VALARIE JEAN (LPC)
Entity type:Individual
Prefix:MS
First Name:VALARIE
Middle Name:JEAN
Last Name:FANE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:29877 TELEGRAPH RD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1332
Mailing Address - Country:US
Mailing Address - Phone:248-358-5334
Mailing Address - Fax:248-356-7596
Practice Address - Street 1:29877 TELEGRAPH RD
Practice Address - Street 2:SUITE 401
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1332
Practice Address - Country:US
Practice Address - Phone:248-358-5334
Practice Address - Fax:248-356-7596
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6401003218101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional