Provider Demographics
NPI:1336624238
Name:ZYLA, VALORIE ANNE (LMHC)
Entity Type:Individual
Prefix:
First Name:VALORIE
Middle Name:ANNE
Last Name:ZYLA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 467
Mailing Address - Street 2:
Mailing Address - City:SAVONA
Mailing Address - State:NY
Mailing Address - Zip Code:14879-0467
Mailing Address - Country:US
Mailing Address - Phone:607-346-2966
Mailing Address - Fax:
Practice Address - Street 1:127 SLY AVE
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-1842
Practice Address - Country:US
Practice Address - Phone:607-346-2966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009571101YM0800X
NY009571-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY009571Medicaid