| Organization Name: | VALERIE WILLIS, LPC, LLC |
| NPI Number: | 1316366768 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VALERIE WILLIS (THERAPIST) |
| Mailing Address: | 108 W Merchant St Audubon |
| State: | NJ US |
| Postal Code: | 081061424 |
| Phone Number: | 8565460664 |
| Fax Number: | 8565461480 |
| NPI Enumeration Date: | 04/14/2014 |
| NPI Last Update Date: | 04/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 37PC00346500 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |