Provider Demographics
NPI:1548700180
Name:VALLEY BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:VALLEY BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACKELYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA, COBA, LBS
Authorized Official - Phone:724-309-9225
Mailing Address - Street 1:PO BOX 775
Mailing Address - Street 2:
Mailing Address - City:BARTON
Mailing Address - State:OH
Mailing Address - Zip Code:43905-0775
Mailing Address - Country:US
Mailing Address - Phone:740-298-7078
Mailing Address - Fax:740-298-7078
Practice Address - Street 1:70333 BARTON RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8548
Practice Address - Country:US
Practice Address - Phone:740-298-7078
Practice Address - Fax:740-298-7078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH85103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty