Healthcare Provider Details

I. General information

NPI: 1295199644
Provider Name (Legal Business Name): LYNNEA LEANN VALPATIC L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2016
Last Update Date: 04/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6081 SE LANDING WAY #14
STUART FL
34997-1824
US

IV. Provider business mailing address

6081S.E. LANDING WAY APT. 14
STUART FL
34997
US

V. Phone/Fax

Practice location:
  • Phone: 772-485-7075
  • Fax:
Mailing address:
  • Phone: 772-485-7075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW5563
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: