Provider Demographics
NPI:1134286347
Name:GINACH, MICHAL ADIV (LCSW PSY D)
Entity Type:Individual
Prefix:DR
First Name:MICHAL
Middle Name:ADIV
Last Name:GINACH
Suffix:
Gender:F
Credentials:LCSW PSY D
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:19 E 88TH ST
Mailing Address - Street 2:APARTMENT 3E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0557
Mailing Address - Country:US
Mailing Address - Phone:212-496-7599
Mailing Address - Fax:212-427-1323
Practice Address - Street 1:11 RIVERSIDE DR
Practice Address - Street 2:WEST WING #2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2504
Practice Address - Country:US
Practice Address - Phone:212-496-7599
Practice Address - Fax:212-427-1323
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYRO31323-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP2100915OtherOXFORD HEALTH PLANS