Active NPI
Jennifer Ann Della Valle, ATR-BC, LCAT
- Art Therapist
- Shirley, NY
National Provider Identifier
1700439247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Art Therapist
- License
- 002151
- Practice address
- 2 Coraci Blvd Ste 10
Shirley, NY 11967-4833 - Phone
- (631) 494-6389
- NPI assigned
- Jul 23, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Art Therapist | 221700000X | 002151 | NY | Primary |
Addresses
Primary practice location
2 Coraci Blvd Ste 10
Shirley, NY 11967-4833
Mailing address
7 Mallard Dr
Center Moriches, NY 11934-3118
Phone (631) 494-6389
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563840000000",
"number": "1700439247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 MALLARD DR",
"city": "CENTER MORICHES",
"state": "NY",
"postal_code": "119343118",
"telephone_number": "631-494-6389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 CORACI BLVD STE 10",
"city": "SHIRLEY",
"state": "NY",
"postal_code": "119674833",
"telephone_number": "631-494-6389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELLA VALLE",
"first_name": "JENNIFER",
"middle_name": "ANN",
"credential": "ATR-BC, LCAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-23",
"last_updated": "2019-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "221700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Art Therapist",
"state": "NY",
"license": "002151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shirley, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.