Provider Demographics
NPI:1003120353
Name:GUMBS, CAHLELAH LOVINA (LCSW)
Entity Type:Individual
Prefix:
First Name:CAHLELAH
Middle Name:LOVINA
Last Name:GUMBS
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 1:15 W 139TH ST APT 17R
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1520
Mailing Address - Country:US
Mailing Address - Phone:646-717-1073
Mailing Address - Fax:
Practice Address - Street 1:306 LENOX AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4465
Practice Address - Country:US
Practice Address - Phone:212-803-2850
Practice Address - Fax:212-850-2899
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0830251041C0700X
NY082895104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker