Provider Demographics
NPI:1407404239
Name:VALLE, ALEXANDRA MICHELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MICHELLE
Last Name:VALLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 10TH ST APT 4M
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3956
Mailing Address - Country:US
Mailing Address - Phone:432-352-5114
Mailing Address - Fax:
Practice Address - Street 1:341 10TH ST APT 4M
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3956
Practice Address - Country:US
Practice Address - Phone:432-352-5114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY107226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health