Provider Demographics
NPI:1831304401
Name:VALENTINI, LUCIA (CSW)
Entity Type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:VALENTINI
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 BROADWAY
Mailing Address - Street 2:SUITE 304
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2780
Mailing Address - Country:US
Mailing Address - Phone:631-691-0213
Mailing Address - Fax:516-822-2290
Practice Address - Street 1:221 BROADWAY
Practice Address - Street 2:SUITE 304
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2780
Practice Address - Country:US
Practice Address - Phone:631-691-0213
Practice Address - Fax:516-822-2290
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0307371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN26691Medicare UPIN