Provider Demographics
NPI:1629893789
Name:LOUGHREY, VALERIE (MA, CAS, NCSP)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:LOUGHREY
Suffix:
Gender:F
Credentials:MA, CAS, NCSP
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:SIATKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CAS NCSP
Mailing Address - Street 1:5201 LOCH RAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-3522
Mailing Address - Country:US
Mailing Address - Phone:410-989-1010
Mailing Address - Fax:
Practice Address - Street 1:5201 LOCH RAVEN BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-3522
Practice Address - Country:US
Practice Address - Phone:410-960-1365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD34821103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool