Provider Demographics
NPI:1720487275
Name:PRINCE, VALERIE TERREZE (LPC, CAC-II)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:TERREZE
Last Name:PRINCE
Suffix:
Gender:F
Credentials:LPC, CAC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 S MCDONOUGH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-3688
Mailing Address - Country:US
Mailing Address - Phone:850-398-2799
Mailing Address - Fax:
Practice Address - Street 1:149 S MCDONOUGH ST STE 200
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-3688
Practice Address - Country:US
Practice Address - Phone:850-398-2799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-21
Last Update Date:2019-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YA0400X
FLMH12991101YM0800X
GALPC010376101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)