Provider Demographics
NPI:1730911751
Name:VALDEZ, BREECOLE LOUISE (LPC)
Entity type:Individual
Prefix:
First Name:BREECOLE
Middle Name:LOUISE
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BREECOLE
Other - Middle Name:LOUISE
Other - Last Name:VALDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BREECOLE VALDEZ, LPC
Mailing Address - Street 1:PO BOX 1449
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85299-1449
Mailing Address - Country:US
Mailing Address - Phone:480-215-8331
Mailing Address - Fax:
Practice Address - Street 1:2 N CENTRAL AVE FL 18
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-2322
Practice Address - Country:US
Practice Address - Phone:646-941-7645
Practice Address - Fax:929-596-7897
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-21992101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health