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General NPI Number Information
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NPI Number | 1295305027
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Entity Type | Individual
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Provider Name | CAROL JANETTE VALLEJO MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/24/2021
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 254 S 1470 E STE 201
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City | SAINT GEORGE
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State | UT
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Zip | 84790-2762
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Country | US
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Telephone | 435-932-3672
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Fax |
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Provider Business Mailing Address
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Address Line | 139 S JUNCTION AVE
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City | CAVE JUNCTION
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State | OR
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Zip | 97523-9006
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Country | US
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Telephone | 435-229-7805
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Fax | 458-592-1622
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 12348416-3501
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-22489
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L15353
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License Number State | OR
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