Provider Demographics
NPI:1962177006
Name:CHAVEZ VALENZUELA, MICHELLE A (LMHC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:A
Last Name:CHAVEZ VALENZUELA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6102 SUMMER RAY RD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-6115
Mailing Address - Country:US
Mailing Address - Phone:505-720-1659
Mailing Address - Fax:
Practice Address - Street 1:1005 21ST ST SE STE 14
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-4030
Practice Address - Country:US
Practice Address - Phone:505-518-5757
Practice Address - Fax:505-461-6217
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTL0219361101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health