Healthcare Provider Details

I. General information

NPI: 1780593020
Provider Name (Legal Business Name): LORENA VALLE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4802 E RAY RD STE 23-358
PHOENIX AZ
85044-6405
US

IV. Provider business mailing address

4802 E RAY RD STE 23-358
PHOENIX AZ
85044-6405
US

V. Phone/Fax

Practice location:
  • Phone: 480-809-7681
  • Fax:
Mailing address:
  • Phone: 480-809-7681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-23980
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: