Provider Demographics
NPI:1164989315
Name:VALES, BRIANA (LSW)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:VALES
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3771 SHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-1939
Mailing Address - Country:US
Mailing Address - Phone:216-978-2745
Mailing Address - Fax:
Practice Address - Street 1:6001 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44104-2762
Practice Address - Country:US
Practice Address - Phone:216-431-2018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
OHS.1903317104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker