MEDICARE: TENITA MARIE VALLES LMHC

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	MHC01052	RI

General Provider Information

NPI Number	:	1467992313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TENITA MARIE VALLES LMHC

Provider Business Mailing Address
First Line	:	530 N MAIN ST
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02904-5762
Country	:	US
Telephone Number	:	401-345-1536
Fax Number	:

Provider Business Practice Location Address
First Line	:	530 N MAIN ST
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02904-5762
Country	:	US
Telephone Number	:	401-383-7509
Fax Number	:

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

Provider Enumeration Date	:	02/26/2017
Last Update Date	:	06/01/2026

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