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NPI Code Detail

MEDICARE: VALERIE THEODORE LCPC

MEDICARE: VALERIE THEODORE LCPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLGP6917MD
2101YP2500XProfessional CounselorLC12035MD

General Provider Information

NPI Number : 1487206736
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALERIE THEODORE LCPC
Provider Business Mailing Address
First Line : 1282 SMALLWOOD DR W STE 559
Second Line :
City : WALDORF
State : MD
Zip : 20603-4732
Country : US
Telephone Number : 917-936-6808
Fax Number :
Provider Business Practice Location Address
First Line : 8200 PROFESSIONAL PL STE 104
Second Line :
City : LANDOVER
State : MD
Zip : 20785-2293
Country : US
Telephone Number : 301-306-2428
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2019
Last Update Date : 04/13/2026

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Directions to “ VALERIE THEODORE LCPC” Practice Location

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