Provider Demographics
NPI:1457956211
Name:BOLLETINO, VALERIE R (LCSW)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:R
Last Name:BOLLETINO
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 RITTENHOUSE DR
Mailing Address - Street 2:
Mailing Address - City:DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-5111
Mailing Address - Country:US
Mailing Address - Phone:609-970-5797
Mailing Address - Fax:
Practice Address - Street 1:815 CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:PROSPECT PARK
Practice Address - State:PA
Practice Address - Zip Code:19076-2322
Practice Address - Country:US
Practice Address - Phone:973-264-0023
Practice Address - Fax:973-264-0022
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0236251041C0700X
NJ44SC063768001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical