Provider Demographics
NPI:1548269418
Name:VALLEY, CYNTHIA KAY (PHD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:KAY
Last Name:VALLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1549 CLAIRMONT RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-4639
Mailing Address - Country:US
Mailing Address - Phone:404-788-0195
Mailing Address - Fax:
Practice Address - Street 1:1549 CLAIRMONT RD
Practice Address - Street 2:SUITE 108
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-4639
Practice Address - Country:US
Practice Address - Phone:404-788-0195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003617103TC1900X
PAPS-008516-L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000122536OtherHIGHMARK
GA471057197OtherIRS