MEDICARE: TONIE M. VALESANO, LCSW A PROFESSIONAL CORPORATION

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	225C00000X	Rehabilitation Counselor	4894-C	NV
2	2084P0804X	Child & Adolescent Psychiatry Physician	815	NV
3	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	:	1346383296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TONIE M. VALESANO, LCSW A PROFESSIONAL CORPORATION

Provider Business Mailing 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	:	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	:	702-754-0808

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TONIE MARIE VALESANO
Credential	:	PHD, LCSW
Telephone Number	:	702-754-0807

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	05/03/2017

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