Provider Demographics
NPI:1710286638
Name:VALENTE, KATHARINE ANGELA (LCSW-C)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:ANGELA
Last Name:VALENTE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3826
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21705-3826
Mailing Address - Country:US
Mailing Address - Phone:301-662-0099
Mailing Address - Fax:301-695-2716
Practice Address - Street 1:9030 RTE 108
Practice Address - Street 2:SUITE A
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1990
Practice Address - Country:US
Practice Address - Phone:410-740-1901
Practice Address - Fax:410-740-2503
Is Sole Proprietor?:No
Enumeration Date:2011-03-17
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD166591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD264161501Medicaid
927LMedicare PIN