1427047901 NPI number — VALERIE CATHERINE DEVILLE LMHC

Table of content: VALERIE CATHERINE DEVILLE LMHC (NPI 1427047901)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427047901 NPI number — VALERIE CATHERINE DEVILLE LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEVILLE
Provider First Name:
VALERIE
Provider Middle Name:
CATHERINE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427047901
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
419 GLORIA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT AUGUSTINE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32086-7835
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-540-2840
Provider Business Mailing Address Fax Number:
904-209-5132

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2225 A1A SO
Provider Second Line Business Practice Location Address:
STE B5
Provider Business Practice Location Address City Name:
SAINT AUGUSTINE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32080-7906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-540-2840
Provider Business Practice Location Address Fax Number:
904-209-5132
Provider Enumeration Date:
10/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MH8104 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: Z086F . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 766576800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 025118800 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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