Provider Demographics
NPI:1932239498
Name:PALEY, VICKI RAE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:RAE
Last Name:PALEY
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 1:5 TRAVERS ST
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-2223
Mailing Address - Country:US
Mailing Address - Phone:516-627-5009
Mailing Address - Fax:516-484-7478
Practice Address - Street 1:5 TRAVERS ST
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-2223
Practice Address - Country:US
Practice Address - Phone:516-627-5009
Practice Address - Fax:516-484-7478
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR04148411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
6388465OtherOXFORD
N99751VPMedicare ID - Type Unspecified