Provider Demographics
NPI:1972392371
Name:VALENZUELA, LINDA VICTORIA (LMSW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:VICTORIA
Last Name:VALENZUELA
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10302 S PANTANO KNOLLS DR
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-0078
Mailing Address - Country:US
Mailing Address - Phone:520-798-8403
Mailing Address - Fax:
Practice Address - Street 1:3148 N CHERRY AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2749
Practice Address - Country:US
Practice Address - Phone:520-789-8403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.114074104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty