Tanisha Renette Valenzuela-Landrum, MS, LMHP-R

Individual provider Active NPI Mental Health Counselor · Axton, VA

NPI 1023801099 · NPPES record last updated May 23, 2025

Key facts

NPI
1023801099
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
0704015705 (VA)
Practice address
1315 Cobbs Knob Rd
Axton, VA 24054-1840
Phone
(434) 228-8415
Fax
(434) 228-8415
NPI assigned
May 23, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0704015705VAMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0704015705 VA Yes

Addresses

Primary practice location

1315 Cobbs Knob Rd
Axton, VA 24054-1840

Mailing address

1315 Cobbs Knob Rd
Axton, VA 24054-1840
Phone (434) 228-8415

Other providers in Axton, VA

All providers in Axton, VA · Mental Health Counselor in Virginia

Sources for this page

Verify at the official NPI Registry.