Healthcare Provider Details

I. General information

NPI: 1699361931
Provider Name (Legal Business Name): BEYOND YOUR VALLEY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2020
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9545 KENWOOD RD STE 304
BLUE ASH OH
45242-6100
US

IV. Provider business mailing address

9545 KENWOOD RD STE 304
BLUE ASH OH
45242-6100
US

V. Phone/Fax

Practice location:
  • Phone: 513-348-1780
  • Fax:
Mailing address:
  • Phone: 513-348-1780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: BRIAN VALASEK
Title or Position: OWNER
Credential: LPCC-S, LPCC-S,LICDC
Phone: 513-348-1780