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General NPI Number Information
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NPI Number | 1568069052
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Entity Type | Individual
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Provider Name | REBECA CARVAJAL VALDES LPC, LCMHC
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Gender | Female
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Dates
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Enumeration Date | 10/07/2020
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 1909 J N PEASE PL STE 101
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City | CHARLOTTE
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State | NC
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Zip | 28262-4509
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Country | US
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Telephone | 980-313-3020
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Fax |
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Provider Business Mailing Address
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Address Line | 931 POLK ST
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City | CHARLOTTE
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State | NC
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Zip | 28206-2931
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Country | US
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Telephone | 202-600-1608
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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