Provider Demographics
NPI:1871277145
Name:VALLETTA, BRIANA (LCSW)
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:VALLETTA
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 1:48 RIVERDALE ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02909-5036
Mailing Address - Country:US
Mailing Address - Phone:201-602-1686
Mailing Address - Fax:
Practice Address - Street 1:1 RICHMOND SQ
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5139
Practice Address - Country:US
Practice Address - Phone:401-785-0040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW032721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical