Provider Demographics
NPI:1356951081
Name:VALERIEMONDESIRLMFT LLC
Entity type:Organization
Organization Name:VALERIEMONDESIRLMFT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MONDESIR
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-898-2197
Mailing Address - Street 1:1406 PARK SHORE CIR APT 4
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9680
Mailing Address - Country:US
Mailing Address - Phone:203-898-2197
Mailing Address - Fax:
Practice Address - Street 1:12 HACKETT CIR S APT 1
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06906-1911
Practice Address - Country:US
Practice Address - Phone:203-898-2197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty