Healthcare Provider Details

I. General information

NPI: 1114155959
Provider Name (Legal Business Name): VALARI QUIMBY LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 07/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 FORBES BLVD STE 122
LANHAM MD
20706-4342
US

IV. Provider business mailing address

4200 FORBES BLVD STE 122
LANHAM MD
20706-4342
US

V. Phone/Fax

Practice location:
  • Phone: 301-731-0383
  • Fax: 301-731-2835
Mailing address:
  • Phone: 301-731-0383
  • Fax: 301-731-2835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberLC2760
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberLC2760
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberLC2760
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberLC2760
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberLC2760
License Number StateMD
# 6
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberLC2760
License Number StateMD
# 7
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License NumberLC2760
License Number StateMD
# 8
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLC2760
License Number StateMD
# 9
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC2760
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: