Provider Demographics
NPI:1932540986
Name:VOGEL, VALERIE ANN (LCSW)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:ANN
Last Name:VOGEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2261 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-4507
Mailing Address - Country:US
Mailing Address - Phone:208-342-5039
Mailing Address - Fax:
Practice Address - Street 1:2261 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-4507
Practice Address - Country:US
Practice Address - Phone:208-342-5039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-07
Last Update Date:2013-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-8491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID$$$$$$$$$OtherSSN