Provider Demographics
NPI:1154500668
Name:SUMLER, GAIL ELLEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:ELLEN
Last Name:SUMLER
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 1:22110 JAMAICA AVE
Mailing Address - Street 2:ROOM 210
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11428-2037
Mailing Address - Country:US
Mailing Address - Phone:718-740-3310
Mailing Address - Fax:718-740-2605
Practice Address - Street 1:22110 JAMAICA AVE
Practice Address - Street 2:ROOM 210
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11428-2037
Practice Address - Country:US
Practice Address - Phone:718-740-3310
Practice Address - Fax:718-740-2605
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR046728-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health