Provider Demographics
NPI:1689450413
Name:SMITH-VALLEY, AILEEN JEANELLE (MA)
Entity Type:Individual
Prefix:
First Name:AILEEN
Middle Name:JEANELLE
Last Name:SMITH-VALLEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:AILEEN
Other - Middle Name:JEANELLE
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:3 POST RD
Mailing Address - Street 2:
Mailing Address - City:CANAAN
Mailing Address - State:NY
Mailing Address - Zip Code:12029-3104
Mailing Address - Country:US
Mailing Address - Phone:518-603-3038
Mailing Address - Fax:
Practice Address - Street 1:3 POST RD
Practice Address - Street 2:
Practice Address - City:CANAAN
Practice Address - State:NY
Practice Address - Zip Code:12029-3104
Practice Address - Country:US
Practice Address - Phone:518-603-3038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP124117101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health