Dickerson, Valencia Deshane

Dickerson, Valencia Deshane is an sole proprietor health care provider with primary practice located at 525 W 5Th St , Covington KY 41011-1259. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Dickerson, Valencia Deshane can be contacted via phone (606) 356-9741.

Contact Information

Primary practice address
525 W 5Th St Covington KY 41011-1259
Phone: (606) 356-9741
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 243847 Kentucky
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 243847 Kentucky
Behavioral Health & Social Service Providers / Professional 101YP2500X 243847 Kentucky

Profile Details

NPI number 1518435759
LBN Legal business name Dickerson, Valencia Deshane
Credentials LPCC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 6th, 2018
Last updated Apr 30th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518435759 NPPES
Kentucky MEDICAID 7100591700

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