Provider Demographics
NPI:1043724073
Name:GALLETTA, VALERIE MARIE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:MARIE
Last Name:GALLETTA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:VALERIE
Other - Middle Name:MARIE
Other - Last Name:POOLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:347 S COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11719-9703
Mailing Address - Country:US
Mailing Address - Phone:631-905-8912
Mailing Address - Fax:631-772-6221
Practice Address - Street 1:408 MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:CENTER MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11934-3523
Practice Address - Country:US
Practice Address - Phone:631-874-0185
Practice Address - Fax:631-909-3558
Is Sole Proprietor?:No
Enumeration Date:2017-11-29
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY102431-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health