Provider Demographics
NPI:1679516835
Name:JONES-GILES, VALERIE A (LCSW)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:A
Last Name:JONES-GILES
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 1:2732 B9 ROODS CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:NY
Mailing Address - Zip Code:13783
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 HAWLEY ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-3102
Practice Address - Country:US
Practice Address - Phone:607-778-1124
Practice Address - Fax:607-778-1164
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0503341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000155107OtherEXCELLUS (BC/BS)
NY07300050334Medicaid
NYCC8144Medicare ID - Type Unspecified