Basic Information
| Provider Information | |||||||||
| NPI: | 1275776056 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LECLERCQ | ||||||||
| FirstName: | VALERIE | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | ED.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4000 E CHARLESTON BLVD STE 230 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891046659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7029685000 | ||||||||
| FaxNumber: | 7029685050 | ||||||||
| Practice Location | |||||||||
| Address1: | 4000 E CHARLESTON BLVD STE 230 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891046659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7029685000 | ||||||||
| FaxNumber: | 7029685050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2009 | ||||||||
| LastUpdateDate: | 02/26/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | CPC0010 | NV | Y | Behavioral Health & Social Service Providers | Counselor | 101YP2500X | CPC0010 | NV | N | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.