MEDICARE: MRS. VALERIE O PULLEN LCSW

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	171M00000X	Case Manager/Care Coordinator
3	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1366783979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VALERIE O PULLEN LCSW

Provider Business Mailing Address
First Line	:	2812 SERENITY CIR S
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34981-5053
Country	:	US
Telephone Number	:	772-259-6668
Fax Number	:

Provider Business Practice Location Address
First Line	:	2812 SERENITY CIR S
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34981-5053
Country	:	US
Telephone Number	:	772-259-6668
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2013
Last Update Date	:	01/10/2024

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