Healthcare Provider Details

I. General information

NPI: 1427047901
Provider Name (Legal Business Name): VALERIE CATHERINE DEVILLE LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 05/27/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 A1A SO STE B5
SAINT AUGUSTINE FL
32080-7906
US

IV. Provider business mailing address

419 GLORIA ST
SAINT AUGUSTINE FL
32086-7835
US

V. Phone/Fax

Practice location:
  • Phone: 904-540-2840
  • Fax: 904-209-5132
Mailing address:
  • Phone: 904-540-2840
  • Fax: 904-209-5132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH8104
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: