Provider Demographics
NPI:1205303468
Name:DALESSANDRO, SALLY A (LMSW)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:A
Last Name:DALESSANDRO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12306-2403
Mailing Address - Country:US
Mailing Address - Phone:518-390-1511
Mailing Address - Fax:
Practice Address - Street 1:1525 WESTERN AVE STE 1
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-3537
Practice Address - Country:US
Practice Address - Phone:518-390-1511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060656-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker