Healthcare Provider Details

I. General information

NPI: 1750106068
Provider Name (Legal Business Name): KAYLIN VALENCIA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4540 PGA BLVD STE 212
PALM BEACH GARDENS FL
33418-3945
US

IV. Provider business mailing address

11728 SW 1ST ST
CORAL SPRINGS FL
33071-8062
US

V. Phone/Fax

Practice location:
  • Phone: 321-549-7414
  • Fax:
Mailing address:
  • Phone: 540-335-7880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW23289
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: