Individual provider Active NPI

Valderas Barksdale Oliver, LCPC

  • Professional Counselor
  • Owings Mills, MD
National Provider Identifier
1629223532
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC0659 Issued in MD
Practice address
9921 Reisterstown Rd
Suite 3a
Owings Mills, MD 21117-3900
Phone
(410) 262-0707
Fax
(410) 367-7834
NPI assigned
Nov 19, 2008
Last updated
Feb 1, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC0659 MD Primary

Addresses

Primary practice location

9921 Reisterstown Rd
Suite 3a
Owings Mills, MD 21117-3900

Mailing address

9921 Reisterstown Rd
Suite 3a
Owings Mills, MD 21117-3900
Phone (410) 262-0707

Other identifiers 1

IdentifierTypeStateIssuer
020644000MedicaidMD

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC0659MDMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1629223532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9921 REISTERSTOWN RD",
            "address_2": "SUITE 3A",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173900",
            "telephone_number": "410-262-0707",
            "fax_number": "410-367-7834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9921 REISTERSTOWN RD",
            "address_2": "SUITE 3A",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173900",
            "telephone_number": "410-262-0707",
            "fax_number": "410-367-7834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "VALDERAS",
        "middle_name": "BARKSDALE",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-19",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC0659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020644000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.