Provider Demographics
NPI:1053349340
Name:VALLIERE, RICHARD EDWARD (LCSW)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:EDWARD
Last Name:VALLIERE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 STUYVESANT PL
Mailing Address - Street 2:
Mailing Address - City:STUYVESANT
Mailing Address - State:NY
Mailing Address - Zip Code:12173-1915
Mailing Address - Country:US
Mailing Address - Phone:518-758-6229
Mailing Address - Fax:
Practice Address - Street 1:430 E ALLEN ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-2423
Practice Address - Country:US
Practice Address - Phone:518-755-7096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0505101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical