Provider Demographics
NPI:1235670159
Name:VALAMIDES, ASHLEY (LMSW)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:VALAMIDES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6025 HERSCHEL DR
Mailing Address - Street 2:
Mailing Address - City:WATAUGA
Mailing Address - State:TX
Mailing Address - Zip Code:76148-2026
Mailing Address - Country:US
Mailing Address - Phone:214-432-8296
Mailing Address - Fax:214-203-0803
Practice Address - Street 1:6025 HERSCHEL DR
Practice Address - Street 2:
Practice Address - City:WATAUGA
Practice Address - State:TX
Practice Address - Zip Code:76148-2026
Practice Address - Country:US
Practice Address - Phone:214-432-8296
Practice Address - Fax:214-203-0803
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63671251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX63671Medicaid