Provider Demographics
NPI:1124636626
Name:VALLARINO, MONICA G (LGSW)
Entity type:Individual
Prefix:MS
First Name:MONICA
Middle Name:G
Last Name:VALLARINO
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 ONTARIO RD NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-2627
Mailing Address - Country:US
Mailing Address - Phone:240-948-5121
Mailing Address - Fax:
Practice Address - Street 1:1711 KALORAMA RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2623
Practice Address - Country:US
Practice Address - Phone:202-232-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD258751041C0700X
DCLG500834751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD25875OtherMARYLAND BOARD OF SOCIAL WORK
DCLG50083475OtherDC BOARD OF SOCIAL WORK