Provider Demographics
NPI:1487618732
Name:VALENTINE, MARY JEAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:JEAN
Last Name:VALENTINE
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 1:16800 DALLAS PKWY
Mailing Address - Street 2:STE 150
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248
Mailing Address - Country:US
Mailing Address - Phone:972-733-7242
Mailing Address - Fax:972-733-7257
Practice Address - Street 1:16800 DALLAS PKWY
Practice Address - Street 2:STE 150
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248
Practice Address - Country:US
Practice Address - Phone:972-733-7242
Practice Address - Fax:972-733-7257
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS181251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical