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General NPI Number Information
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NPI Number | 1366153025
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Entity Type | Individual
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Provider Name | ALYSSA CATHERINE BALSAMELLO LMSW
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Gender | Female
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Dates
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Enumeration Date | 12/13/2022
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Last Update Date | 12/13/2022
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Provider Practice Location Address
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Address Line | 17 SCENIC DR APT E
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City | CROTON ON HUDSON
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State | NY
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Zip | 10520-1715
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Country | US
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Telephone | 845-544-5055
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Fax |
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Provider Business Mailing Address
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Address Line | 5 FORTUNE RD W # 1094
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City | MIDDLETOWN
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State | NY
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Zip | 10941-1691
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Country | US
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Telephone | 845-544-5055
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 115106
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License Number State | NY
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