Provider Demographics
NPI:1578016721
Name:VALENTE, KELLY (LMFT)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:VALENTE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 NW MEADOW LAKES DR
Mailing Address - Street 2:
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754-1414
Mailing Address - Country:US
Mailing Address - Phone:775-980-5739
Mailing Address - Fax:
Practice Address - Street 1:190 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-1820
Practice Address - Country:US
Practice Address - Phone:757-309-1004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-24
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3354106H00000X
NV02203-I101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)