Provider Demographics
NPI:1033481841
Name:GILBERT, AMY BETH (LCSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:BETH
Last Name:GILBERT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:BETH
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:7 SHETLAND DR
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-3609
Mailing Address - Country:US
Mailing Address - Phone:518-937-2733
Mailing Address - Fax:
Practice Address - Street 1:7 SHETLAND DR
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-3609
Practice Address - Country:US
Practice Address - Phone:518-937-2733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY73 0832991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03008266Medicaid