Provider Demographics
NPI:1720755820
Name:VALVERDE, PAOLA (MALPC, LAC)
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:
Last Name:VALVERDE
Suffix:
Gender:F
Credentials:MALPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1134 PORTRAIT HILL DR
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-6301
Mailing Address - Country:US
Mailing Address - Phone:786-527-5604
Mailing Address - Fax:
Practice Address - Street 1:1134 PORTRAIT HILL DR
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-6301
Practice Address - Country:US
Practice Address - Phone:786-527-5604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC689101YA0400X
SC6757101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)