=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265886410
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VALERIE FLOYD LICSW, LCSW-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/13/2016
-----------------------------------------------------
Last Update Date | 04/13/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15912 CRAIN HWY UNIT B #182
-----------------------------------------------------
City | BRANDYWINE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20613-8035
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-681-9680
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 834
-----------------------------------------------------
City | WHITE PLAINS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20695-0834
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-787-8789
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | LC50077768
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 18120
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------