Provider Demographics
NPI:1447471214
Name:GUTHRIE, VALERIE ANNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:ANNE
Last Name:GUTHRIE
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 1:217 FOURTH STREET
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780
Mailing Address - Country:US
Mailing Address - Phone:631-686-6112
Mailing Address - Fax:
Practice Address - Street 1:FLOWERFIELD BLDG 17
Practice Address - Street 2:PEDERSON KRAG CONTINUED DAY TREATMENT
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780
Practice Address - Country:US
Practice Address - Phone:631-920-8599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR031792-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical