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General NPI Number Information
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NPI Number | 1457956211
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Entity Type | Individual
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Provider Name | VALERIE R BOLLETINO LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/01/2020
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Last Update Date | 03/08/2025
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Provider Practice Location Address
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Address Line | 815 CHESTER PIKE
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City | PROSPECT PARK
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State | PA
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Zip | 19076-2322
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Country | US
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Telephone | 973-264-0023
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Fax | 973-264-0022
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Provider Business Mailing Address
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Address Line | 127 RITTENHOUSE DR
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City | DEPTFORD
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State | NJ
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Zip | 08096-5111
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Country | US
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Telephone | 609-970-5797
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW023625
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC06376800
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License Number State | NJ
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