Provider Demographics
NPI:1174038434
Name:AMALFITANO, GAIL KATHRYN (LMHC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:KATHRYN
Last Name:AMALFITANO
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9873 LAWRENCE RD APT F206
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-3818
Mailing Address - Country:US
Mailing Address - Phone:786-385-4673
Mailing Address - Fax:
Practice Address - Street 1:9873 LAWRENCE RD APT F206
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-3818
Practice Address - Country:US
Practice Address - Phone:786-385-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-08
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17062101YM0800X
FLIMH15734101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH17062OtherFLORIDA STATE LICENSE LMHC
FLIMH15734OtherSTATE LICENSE RMHCI