Provider Demographics
NPI:1265792030
Name:JANEFFER DEL VALLE
Entity type:Organization
Organization Name:JANEFFER DEL VALLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JANEFFER
Authorized Official - Middle Name:E
Authorized Official - Last Name:DEL VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:BA, MS, LPC
Authorized Official - Phone:860-585-8164
Mailing Address - Street 1:194 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-6354
Mailing Address - Country:US
Mailing Address - Phone:860-585-8164
Mailing Address - Fax:
Practice Address - Street 1:194 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-6354
Practice Address - Country:US
Practice Address - Phone:860-585-8164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002068101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty