Provider Demographics
NPI:1235946708
Name:VALLADARES, ASHLEY MARIE (LMHC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:VALLADARES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-5534
Mailing Address - Country:US
Mailing Address - Phone:516-924-7228
Mailing Address - Fax:
Practice Address - Street 1:169 MADISON AVE # 11104
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5101
Practice Address - Country:US
Practice Address - Phone:516-715-3039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015414-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health