Provider Demographics
NPI:1780054437
Name:GALEANO, ALLISE (MS LMFT)
Entity type:Individual
Prefix:MRS
First Name:ALLISE
Middle Name:
Last Name:GALEANO
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:ALLEIS
Other - Middle Name:
Other - Last Name:ESQUIVEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS LMFT
Mailing Address - Street 1:90 SNOW CRYSTAL LN
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-1819
Mailing Address - Country:US
Mailing Address - Phone:626-646-8824
Mailing Address - Fax:
Practice Address - Street 1:230 W 55TH ST APT 5F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5212
Practice Address - Country:US
Practice Address - Phone:626-646-8824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75313106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist