Provider Demographics
NPI:1174165203
Name:VALENCIK, MARIA LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LYNN
Last Name:VALENCIK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5891 BRITTANIA DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-2273
Mailing Address - Country:US
Mailing Address - Phone:775-247-7292
Mailing Address - Fax:
Practice Address - Street 1:63 KEYSTONE AVE STE 301
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-5524
Practice Address - Country:US
Practice Address - Phone:775-247-7292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-10
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9657-C1041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV250004943Medicaid
NV250004943Medicaid