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General NPI Number Information
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NPI Number | 1235946708
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Entity Type | Individual
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Provider Name | ASHLEY MARIE VALLADARES LMHC
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Gender | Female
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 169 MADISON AVE # 11104
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City | NEW YORK
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State | NY
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Zip | 10016-5101
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Country | US
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Telephone | 516-715-3039
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Fax |
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Provider Business Mailing Address
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Address Line | 12 CEDAR AVE
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City | BAY SHORE
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State | NY
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Zip | 11706-5534
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Country | US
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Telephone | 516-924-7228
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 015414-01
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License Number State | NY
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