Provider Demographics
NPI:1093708299
Name:JOSEPHSON, GILDA S (PHD LMHC)
Entity Type:Individual
Prefix:DR
First Name:GILDA
Middle Name:S
Last Name:JOSEPHSON
Suffix:
Gender:F
Credentials:PHD LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2833 NW 41ST ST
Mailing Address - Street 2:#140
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6986
Mailing Address - Country:US
Mailing Address - Phone:352-338-0397
Mailing Address - Fax:352-372-6787
Practice Address - Street 1:2833 NW 41ST ST
Practice Address - Street 2:#140
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6986
Practice Address - Country:US
Practice Address - Phone:352-338-0397
Practice Address - Fax:352-372-6787
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0001377101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ1340OtherBLUE CROSS BLUE SHIELD