Individual provider Active NPI

Kristen Valletta, LCSW, CASAC MASTER

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1043899404
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
081877 Issued in NY
Practice address
215A Joline Ave
Staten Island, NY 10307-2080
Phone
(973) 713-5683
NPI assigned
Apr 5, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC06018400 NJ
Clinical Social Worker 1041C0700X 081877 NY Primary

Addresses

Primary practice location

215A Joline Ave
Staten Island, NY 10307-2080

Mailing address

215A Joline Ave
Staten Island, NY 10307-2080
Phone (718) 818-5777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC06018400NJMDClinical Social Worker
081877NYMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1043899404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215A JOLINE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103072080",
            "telephone_number": "718-818-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215A JOLINE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103072080",
            "telephone_number": "973-713-5683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLETTA",
        "first_name": "KRISTEN",
        "credential": "LCSW, CASAC MASTER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06018400",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.