Healthcare Provider Details

I. General information

NPI: 1295486736
Provider Name (Legal Business Name): JESSICA AIELLO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2022
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 W MARKET ST
RED HOOK NY
12571-1516
US

IV. Provider business mailing address

65 W MARKET ST
RED HOOK NY
12571-1516
US

V. Phone/Fax

Practice location:
  • Phone: 845-758-2241
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number101562
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: