Provider Demographics
NPI:1811017262
Name:NALIETH, PAUL (LCSW-R, PHD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:NALIETH
Suffix:
Gender:M
Credentials:LCSW-R, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 RIDGEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-4315
Mailing Address - Country:US
Mailing Address - Phone:973-262-4556
Mailing Address - Fax:973-731-5808
Practice Address - Street 1:100 N PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-2005
Practice Address - Country:US
Practice Address - Phone:718-260-4814
Practice Address - Fax:718-260-7711
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR051289-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical