Provider Demographics
NPI:1023397924
Name:GAMAUF MCCOY, GAYLE ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:ANN
Last Name:GAMAUF MCCOY
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 1:848 W AINSLIE ST APT 4E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-3946
Mailing Address - Country:US
Mailing Address - Phone:773-293-6676
Mailing Address - Fax:
Practice Address - Street 1:111 N WABASH AVE STE 1105
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3121
Practice Address - Country:US
Practice Address - Phone:773-293-6676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490058201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical