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General NPI Number Information
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NPI Number | 1346383296
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Entity Type | Organization
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Legal Business Name | TONIE M. VALESANO, LCSW A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 05/03/2017
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Provider Practice Location Address
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Address Line | 8685 S EASTERN AVE
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City | LAS VEGAS
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State | NV
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Zip | 89123-2839
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Country | US
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Telephone | 702-754-0807
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Fax | 702-754-0808
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Provider Business Mailing Address
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Address Line | 8685 S EASTERN AVE
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City | LAS VEGAS
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State | NV
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Zip | 89123-2839
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Country | US
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Telephone | 702-754-0807
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Fax | 702-754-0808
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TONIE MARIE VALESANO
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Credential | PHD, LCSW
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Telephone | 702-754-0807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number | 4894-C
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 815
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 4894-C
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License Number State | NV
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