Provider Demographics
NPI:1295529105
Name:VALENTINE-SANSON, JODI LYNNE (LCSWR)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:LYNNE
Last Name:VALENTINE-SANSON
Suffix:
Gender:
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7587 BRIDGEPORT KIRKVILLE RD
Mailing Address - Street 2:
Mailing Address - City:KIRKVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13082-9201
Mailing Address - Country:US
Mailing Address - Phone:315-263-6926
Mailing Address - Fax:
Practice Address - Street 1:5008 BRITTONFIELD PKWY
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9248
Practice Address - Country:US
Practice Address - Phone:315-472-7504
Practice Address - Fax:315-479-8639
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0528651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical