Healthcare Provider Details

I. General information

NPI: 1962328310
Provider Name (Legal Business Name): THREE WILLOWS PSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 PINE WEST PLAZA SUITE 501
ALBANY NY
12205
US

IV. Provider business mailing address

PO BOX 144
SLINGERLANDS NY
12159-0144
US

V. Phone/Fax

Practice location:
  • Phone: 518-722-7637
  • Fax: 518-240-4643
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. EMILEE CARMEN VALLER GORFIEN
Title or Position: CO-OWNER/PSYCHOLOGIST
Credential: PHD
Phone: 518-722-7637