Provider Demographics
NPI:1083856702
Name:GOCKEL, ANNEMARIE (MSW,PHD)
Entity Type:Individual
Prefix:MS
First Name:ANNEMARIE
Middle Name:
Last Name:GOCKEL
Suffix:
Gender:F
Credentials:MSW,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 GOTHIC ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3047
Mailing Address - Country:US
Mailing Address - Phone:925-817-0209
Mailing Address - Fax:
Practice Address - Street 1:57 GOTHIC ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3047
Practice Address - Country:US
Practice Address - Phone:925-817-0209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-26
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1150871041C0700X
MA9491103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical