Individual provider Active NPI

Joanne M Della Valle, LCSW

  • Clinical Social Worker
  • East Patchogue, NY
National Provider Identifier
1649648635
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
082915-1 Issued in NY
Practice address
240 Patchogue Yaphank Rd
Suite 211
East Patchogue, NY 11772-4868
Phone
(631) 758-2815
NPI assigned
Sep 8, 2015
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 082915-1 NY Primary

Addresses

Primary practice location

240 Patchogue Yaphank Rd
Suite 211
East Patchogue, NY 11772-4868

Mailing address

7 Stephanie LN
Manorville, NY 11949-2537
Phone (631) 926-2358

Other practice location 1

1050 Hallock Ave
Port Jefferson Station, NY 11776-1214
Phone (631) 576-4736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161005000113 NY Practitioner - Clinical Social Worker 7315235496 Reassigns benefits to 1 organization
Practice locations: Center Moriches, NY; Shirley, NY; Port Jefferson Station, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Stony Brook, School of Medicine, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1050 Hallock Ave
Suite 4
Port Jefferson Station, NY 11776-1214
Phone (631) 576-4736

5 D Canal St
Center Moriches, NY 11934-3501
Phone (631) 576-4736

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
082915-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Medical Practice P.C. CurrentSince Aug 1, 2016 Accepting new patients
Joanne Della Valle LCSW P.C. Clinical CurrentSince Mar 23, 2020 Accepting new patients
Atul N. Shah, MD, PC PastSince Jan 29, 2008 Accepting new patients

Locations

240 Patchogue Yaphank Rd
Ste 211
East Patchogue, NY 11772
Phone (631) 758-2815

1050 Hallock Ave
Port Jefferson Station, NY 11776
Phone (631) 355-6022

1050 Hallock Ave
Ste 4
Port Jefferson Station, NY 11776
Phone (631) 203-7642

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1649648635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 STEPHANIE LN",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492537",
            "telephone_number": "631-926-2358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 PATCHOGUE YAPHANK RD",
            "address_2": "SUITE 211",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724868",
            "telephone_number": "631-758-2815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Hallock Ave",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson Station",
            "state": "NY",
            "postal_code": "117761214",
            "country_code": "US",
            "telephone_number": "631-576-4736",
            "fax_number": "631-206-9299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELLA VALLE",
        "first_name": "JOANNE",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082915-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

Verify at the official NPI Registry.