Provider Demographics
NPI:1811124902
Name:LENTZ, VALERIE LOUISE
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:LOUISE
Last Name:LENTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 DALEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-6630
Mailing Address - Country:US
Mailing Address - Phone:630-300-4171
Mailing Address - Fax:815-725-5150
Practice Address - Street 1:2215 DALEWOOD CT
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-6630
Practice Address - Country:US
Practice Address - Phone:630-300-4171
Practice Address - Fax:815-725-5150
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0126791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical