Provider Demographics
NPI:1881025435
Name:VALERIO-NEGRON, ESTEPHANY MELIZA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ESTEPHANY
Middle Name:MELIZA
Last Name:VALERIO-NEGRON
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 1:1931 BLACK ROCK TPKE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-3506
Mailing Address - Country:US
Mailing Address - Phone:203-384-8681
Mailing Address - Fax:203-384-0722
Practice Address - Street 1:1931 BLACK ROCK TPKE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-3506
Practice Address - Country:US
Practice Address - Phone:203-384-8681
Practice Address - Fax:203-384-0722
Is Sole Proprietor?:No
Enumeration Date:2013-12-09
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090890104100000X
NY0854061041C0700X
CT0113011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04015472Medicaid
NY571000Medicare Oscar/Certification
NY331043Medicare Oscar/Certification
NY331978Medicare Oscar/Certification
NY331945Medicare Oscar/Certification
NY331954Medicare Oscar/Certification
NY331957Medicare Oscar/Certification
NY571056Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
NY331009Medicare Oscar/Certification
NY331946Medicare Oscar/Certification
NY331943Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification
NY331058Medicare Oscar/Certification
NY331944Medicare Oscar/Certification
NY331947Medicare Oscar/Certification
NY331952Medicare Oscar/Certification