Provider Demographics
NPI:1487145777
Name:VALENTINO-BOTTARO, JENENNE R (LMHC)
Entity type:Individual
Prefix:DR
First Name:JENENNE
Middle Name:R
Last Name:VALENTINO-BOTTARO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:JENENNE
Other - Middle Name:R
Other - Last Name:VALENTINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC-S
Mailing Address - Street 1:720 US HIGHWAY 441
Mailing Address - Street 2:#1079
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159
Mailing Address - Country:US
Mailing Address - Phone:352-636-5466
Mailing Address - Fax:
Practice Address - Street 1:6017 SE ROBINSON RD
Practice Address - Street 2:
Practice Address - City:BELLEVIEW
Practice Address - State:FL
Practice Address - Zip Code:34420-3307
Practice Address - Country:US
Practice Address - Phone:352-347-4663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15996101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health