Provider Demographics
NPI:1447897947
Name:COLORADO, VALERIE LEEANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:LEEANN
Last Name:COLORADO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:VALERIE
Other - Middle Name:LEEANN
Other - Last Name:RAINEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:3804 SPENCER ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-7634
Mailing Address - Country:US
Mailing Address - Phone:817-371-3745
Mailing Address - Fax:
Practice Address - Street 1:9500 RAY WHITE RD STE 245
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6000
Practice Address - Country:US
Practice Address - Phone:817-371-3745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68417101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional