Provider Demographics
NPI:1487098786
Name:VALDES, KIM (LPC)
Entity type:Individual
Prefix:MRS
First Name:KIM
Middle Name:
Last Name:VALDES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:KIM
Other - Middle Name:
Other - Last Name:VALDES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAPC
Mailing Address - Street 1:550 KIMBALL CREST CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-6419
Mailing Address - Country:US
Mailing Address - Phone:404-957-4317
Mailing Address - Fax:877-505-5278
Practice Address - Street 1:310 MAXWELL RD
Practice Address - Street 2:SUITE 600A
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-2065
Practice Address - Country:US
Practice Address - Phone:404-957-4317
Practice Address - Fax:770-343-8926
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008329101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health