Provider Demographics
NPI:1043681844
Name:VALENTINE, LESLIE (LISW-S)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6906 REGENCY DR
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-6158
Mailing Address - Country:US
Mailing Address - Phone:440-668-1294
Mailing Address - Fax:
Practice Address - Street 1:6906 REGENCY DR
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-6158
Practice Address - Country:US
Practice Address - Phone:440-668-1294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.08001871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical