Provider Demographics
NPI:1073699369
Name:GERSHOWITZ, NINA (LCSW)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:GERSHOWITZ
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 1:524 VIEWPOINT TER
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-6209
Mailing Address - Country:US
Mailing Address - Phone:914-588-0075
Mailing Address - Fax:
Practice Address - Street 1:524 VIEWPOINT TER
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-6209
Practice Address - Country:US
Practice Address - Phone:914-588-0075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR046570-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY115050OtherVALUE OPTIONS
NY7198470OtherAETNA BEHAVIORAL HEALTH
NYP2824822OtherOXFORD BEHAVIORAL HEALTH
NYNY2421Medicare ID - Type Unspecified