Provider Demographics
NPI:1255800421
Name:BROWN, VALARIE (PEER SUPPORT, CDCA)
Entity type:Individual
Prefix:
First Name:VALARIE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:PEER SUPPORT, CDCA
Other - Prefix:
Other - First Name:VALARIE
Other - Middle Name:
Other - Last Name:TYSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CDCA, PEER SUPPORT
Mailing Address - Street 1:600 SUPERIOR AVE E STE 1800
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-2654
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4117 DUNDEE AVE APT B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-2336
Practice Address - Country:US
Practice Address - Phone:614-735-1923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-17
Last Update Date:2018-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist