Provider Demographics
NPI:1154860609
Name:BRINDISI, VALLENA
Entity Type:Individual
Prefix:
First Name:VALLENA
Middle Name:
Last Name:BRINDISI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VALLENA
Other - Middle Name:
Other - Last Name:BIRCHEFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:85 E 10TH ST
Mailing Address - Street 2:APT C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-5406
Mailing Address - Country:US
Mailing Address - Phone:909-969-4669
Mailing Address - Fax:
Practice Address - Street 1:85 E 10TH ST
Practice Address - Street 2:APT C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-5406
Practice Address - Country:US
Practice Address - Phone:909-969-4669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY09920611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical