Basic Information
| Provider Information | |||||||||
| NPI: | 1033697750 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VALONE | ||||||||
| FirstName: | CARMELO | ||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5300 ANGELES VISTA BLVD | ||||||||
| Address2: | |||||||||
| City: | VIEW PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900431648 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3232954555 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6762 LEXINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900381217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3233807590 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2018 | ||||||||
| LastUpdateDate: | 09/24/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator | 1041C0700X | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.