Healthcare Provider Details

I. General information

NPI: 1053240572
Provider Name (Legal Business Name): VALONZO CLINICAL SERVICES LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 LAW PL
STATEN ISLAND NY
10310
US

IV. Provider business mailing address

11 LAW PL
STATEN ISLAND NY
10310
US

V. Phone/Fax

Practice location:
  • Phone: 917-975-6219
  • Fax:
Mailing address:
  • Phone: 917-975-6219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: GERALYN VALONZO
Title or Position: SOCIAL WORKER/PRACTICE OWNER
Credential: LCSW
Phone: 908-768-2640