MEDICARE: JESSICA C GELGAND-VALENCIA LMFT

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	101YM0800X	Mental Health Counselor	202716	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	85-0204142	OTHER	NM	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366787160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA C GELGAND-VALENCIA LMFT

Provider Business Mailing Address
First Line	:	13706 RESEARCH BLVD STE 114
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-1838
Country	:	US
Telephone Number	:	575-640-3112
Fax Number	:

Provider Business Practice Location Address
First Line	:	13706 RESEARCH BLVD STE 114
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-1838
Country	:	US
Telephone Number	:	575-640-3112
Fax Number	:

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

Provider Enumeration Date	:	12/05/2012
Last Update Date	:	07/23/2019

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