Provider Demographics
NPI:1003145384
Name:BIALK, GAIL (LCSW)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:BIALK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:
Other - Last Name:YAUNKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12791 WORLD PLAZA LN BLDG 89
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3989
Mailing Address - Country:US
Mailing Address - Phone:239-829-5494
Mailing Address - Fax:239-645-4777
Practice Address - Street 1:12791 WORLD PLAZA LN BLDG 89
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3989
Practice Address - Country:US
Practice Address - Phone:239-829-5494
Practice Address - Fax:239-645-4777
Is Sole Proprietor?:No
Enumeration Date:2009-12-15
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI127934-121171M00000X
FLSW137491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator