Provider Demographics
NPI:1730654179
Name:VALDES, GREYSY ESTRELLA (LCSW)
Entity Type:Individual
Prefix:
First Name:GREYSY
Middle Name:ESTRELLA
Last Name:VALDES
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 1:475 BANTA AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-2149
Mailing Address - Country:US
Mailing Address - Phone:201-294-7445
Mailing Address - Fax:
Practice Address - Street 1:475 BANTA AVE APT 2
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-2149
Practice Address - Country:US
Practice Address - Phone:201-294-7445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC058156001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical