Provider Demographics
NPI:1831398916
Name:VALENTINE, JILL EILEEN (LCSW)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:EILEEN
Last Name:VALENTINE
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 1:1224 S RIVER RD STE B235
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8285
Mailing Address - Country:US
Mailing Address - Phone:435-619-0326
Mailing Address - Fax:866-507-8684
Practice Address - Street 1:1224 S RIVER RD STE B235
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-8285
Practice Address - Country:US
Practice Address - Phone:435-619-0326
Practice Address - Fax:866-507-8684
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT131973-3501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health