Provider Demographics
NPI:1982683702
Name:FOLSOM-MARTIN, VALERIE L (LCSW)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:L
Last Name:FOLSOM-MARTIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4427 WAYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-8426
Mailing Address - Country:US
Mailing Address - Phone:239-260-1978
Mailing Address - Fax:239-260-1978
Practice Address - Street 1:4427 WAYSIDE DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-8426
Practice Address - Country:US
Practice Address - Phone:239-260-1978
Practice Address - Fax:239-260-1978
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0034901041C0700X
FLSW16289101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2873423Medicare ID - Type Unspecified