Provider Demographics
NPI:1225193980
Name:GALE, MARLA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:
Last Name:GALE
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 1:7168 CATALUNA CIR
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-3176
Mailing Address - Country:US
Mailing Address - Phone:561-716-0888
Mailing Address - Fax:561-637-3377
Practice Address - Street 1:7168 CATALUNA CIR
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-3176
Practice Address - Country:US
Practice Address - Phone:561-716-0888
Practice Address - Fax:561-637-3377
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-23
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW0000056101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW0000056OtherLCSW FL
FLZ5043Medicare PIN