Healthcare Provider Details

I. General information

NPI: 1932074879
Provider Name (Legal Business Name): AMBER NICOLE VALENTINE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST STE C400
LEXINGTON KY
40536-7001
US

IV. Provider business mailing address

800 ROSE ST STE C425
LEXINGTON KY
40536-7001
US

V. Phone/Fax

Practice location:
  • Phone: 859-257-4554
  • Fax: 859-257-8978
Mailing address:
  • Phone: 859-257-4554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number259495
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: