Provider Demographics
NPI:1538563275
Name:VALENTINE, BRITTANY (LISW)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44303-1406
Mailing Address - Country:US
Mailing Address - Phone:330-996-4600
Mailing Address - Fax:330-643-0767
Practice Address - Street 1:611 W MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44303-1406
Practice Address - Country:US
Practice Address - Phone:330-996-4600
Practice Address - Fax:330-643-0767
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
OHI19014951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2846675Medicaid