Provider Demographics
NPI:1831396977
Name:VALLONE, MICHELE D (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:D
Last Name:VALLONE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE BELLEVUE ADDRESS
Mailing Address - Street 2:SUITE 7
Mailing Address - City:UPPER MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1412
Mailing Address - Country:US
Mailing Address - Phone:201-572-9519
Mailing Address - Fax:
Practice Address - Street 1:ONE BELLEVUE ADDRESS
Practice Address - Street 2:SUITE 7
Practice Address - City:UPPER MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043
Practice Address - Country:US
Practice Address - Phone:201-572-9519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2018-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05014500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ44SL05014500OtherSOCIAL WORK LICENSE