Provider Demographics
NPI:1184850620
Name:LIGONDE MINOR, GINA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:
Last Name:LIGONDE MINOR
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 1:13 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5003
Mailing Address - Country:US
Mailing Address - Phone:845-849-4031
Mailing Address - Fax:
Practice Address - Street 1:13 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5003
Practice Address - Country:US
Practice Address - Phone:845-849-4031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0753591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical