MEDICARE: MR. FRANKIE ESTEBAN VALLE LMHC, NCC, CAP, NCGC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	4598	FL
2	101YM0800X	Mental Health Counselor	MH10808	FL

General Provider Information

NPI Number	:	1790914083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FRANKIE ESTEBAN VALLE LMHC, NCC, CAP, NCGC

Provider Business Mailing Address
First Line	:	9225 BAY PLAZA BLVD
Second Line	:	SUITE 418
City	:	TAMPA
State	:	FL
Zip	:	33619-4466
Country	:	US
Telephone Number	:	813-781-7475
Fax Number	:	813-630-4670

Provider Business Practice Location Address
First Line	:	9225 BAY PLAZA BLVD
Second Line	:	SUITE 418
City	:	TAMPA
State	:	FL
Zip	:	33619-4466
Country	:	US
Telephone Number	:	813-701-1234
Fax Number	:	813-630-4670

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

Provider Enumeration Date	:	07/08/2009
Last Update Date	:	03/04/2014

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