Provider Demographics
NPI:1659163020
Name:VALENTINE, MAYSUN JACQUELYN (LMHCA)
Entity type:Individual
Prefix:
First Name:MAYSUN
Middle Name:JACQUELYN
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:M
Other - Middle Name:J
Other - Last Name:VALENTINE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHCA
Mailing Address - Street 1:1250 S PUGET DR APT H217
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-4432
Mailing Address - Country:US
Mailing Address - Phone:425-209-7144
Mailing Address - Fax:
Practice Address - Street 1:15811 AMBAUM BLVD SW STE 110
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-3071
Practice Address - Country:US
Practice Address - Phone:206-242-8211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMHCA.MC.61678538101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health