MEDICARE: VALLEY'S EDGE INTEGRATIVE COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1205485034
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY'S EDGE INTEGRATIVE COUNSELING

Provider Business Mailing Address
First Line	:	702 N ENGLEWOOD AVE
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36303-2582
Country	:	US
Telephone Number	:	334-487-3457
Fax Number	:	334-203-9443

Provider Business Practice Location Address
First Line	:	702 N ENGLEWOOD AVE
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36303-2582
Country	:	US
Telephone Number	:	334-487-3457
Fax Number	:	334-203-9443

Authorized Official
Title or Position	:	PRESIDENT/DIRECTOR
Name	:	JOY RABON
Credential	:	LMFT
Telephone Number	:	334-487-3457

Provider Enumeration Date	:	09/04/2019
Last Update Date	:	05/11/2025

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