1073852588 NPI number — MS. CLARE LESLIE GEBEY LSW, LCSW-NY

Table of content: MS. CLARE LESLIE GEBEY LSW, LCSW-NY (NPI 1073852588)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073852588 NPI number — MS. CLARE LESLIE GEBEY LSW, LCSW-NY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEBEY
Provider First Name:
CLARE
Provider Middle Name:
LESLIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LSW, LCSW-NY
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LAROSA
Provider Other First Name:
CLARE
Provider Other Middle Name:
LESLIE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LSW, LCSW-NY
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1073852588
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/04/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1650 BROADWAY
Provider Second Line Business Mailing Address:
KIDSPEACE, CAPTAIN WILEY BUILDING, 2ND FLOOR
Provider Business Mailing Address City Name:
BETHLEHEM
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18015-3904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-799-7343
Provider Business Mailing Address Fax Number:
610-799-8230

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1650 BROADWAY
Provider Second Line Business Practice Location Address:
KIDSPEACE, CAPTAIN WILEY BUILDING, 2ND FLOOR
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18015-3904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-799-7343
Provider Business Practice Location Address Fax Number:
610-799-8230
Provider Enumeration Date:
02/04/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  0727981 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171M00000X , with the licence number: SW012011L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)