Healthcare Provider Details

I. General information

NPI: 1073065892
Provider Name (Legal Business Name): JENNIFER VALENTA LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2016
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10203 TANAGER LN STE 102
COLUMBIA MD
21044-4171
US

IV. Provider business mailing address

10203 TANAGER LN STE 102
COLUMBIA MD
21044-4171
US

V. Phone/Fax

Practice location:
  • Phone: 410-397-7675
  • Fax:
Mailing address:
  • Phone: 410-397-7675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number21271
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number21271
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: