Healthcare Provider Details

I. General information

NPI: 1548681851
Provider Name (Legal Business Name): LORI A VALENTINO-SMITH MSS, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2014
Last Update Date: 01/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 W WELSH POOL RD
EXTON PA
19341-1200
US

IV. Provider business mailing address

209 WENTWORTH RD
WAYNE PA
19087-2448
US

V. Phone/Fax

Practice location:
  • Phone: 610-213-4316
  • Fax:
Mailing address:
  • Phone: 610-213-4316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCW017921
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW017921
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: