Provider Demographics
NPI:1639470677
Name:SCARBERRY, VALERIE JUNE (MA, LPC, CMIII)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:JUNE
Last Name:SCARBERRY
Suffix:
Gender:F
Credentials:MA, LPC, CMIII
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:JUNE
Other - Last Name:SWITCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC, CMIII
Mailing Address - Street 1:1010 E 45TH ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-2202
Mailing Address - Country:US
Mailing Address - Phone:405-273-1170
Mailing Address - Fax:405-275-5132
Practice Address - Street 1:101 N UNION AVE
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-7067
Practice Address - Country:US
Practice Address - Phone:405-275-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-08
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5058101YP2500X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1639470677Medicaid