MEDICARE: LAURA R VALENCIA 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	016948	NY

General Provider Information

NPI Number	:	1962125138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA R VALENCIA LMHC

Provider Business Mailing Address
First Line	:	4254 JUDGE ST APT 6G
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-2590
Country	:	US
Telephone Number	:	347-522-0764
Fax Number	:

Provider Business Practice Location Address
First Line	:	9109 ROOSEVELT AVE FL 2
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7995
Country	:	US
Telephone Number	:	718-908-8000
Fax Number	:

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

Provider Enumeration Date	:	09/22/2022
Last Update Date	:	11/07/2025

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