Provider Demographics
NPI:1326791468
Name:VALENTICH, GLENDA MARIA (LCSW)
Entity type:Individual
Prefix:
First Name:GLENDA
Middle Name:MARIA
Last Name:VALENTICH
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 1:10245 S ROLLING WATER DR
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-0528
Mailing Address - Country:US
Mailing Address - Phone:352-636-4626
Mailing Address - Fax:
Practice Address - Street 1:1452 HUGHES RD STE 200
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-9221
Practice Address - Country:US
Practice Address - Phone:817-366-9740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX589491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical