MEDICARE: DR. TONIE VALESANO PHD, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	4894-C	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346284189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TONIE VALESANO PHD, LCSW

Provider Business Mailing Address
First Line	:	2904 W HORIZON RIDGE PKWY
Second Line	:	SUITE 101
City	:	HENDERSON
State	:	NV
Zip	:	89052-5015
Country	:	US
Telephone Number	:	702-292-3774
Fax Number	:	702-754-0808

Provider Business Practice Location Address
First Line	:	8685 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2839
Country	:	US
Telephone Number	:	702-754-0807
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	07/01/2021

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