Provider Demographics
NPI:1235452079
Name:GILMARTIN, ELAINE ALISON (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:ALISON
Last Name:GILMARTIN
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 1:8 HENDRIE LN
Mailing Address - Street 2:
Mailing Address - City:GREENLAWN
Mailing Address - State:NY
Mailing Address - Zip Code:11740-1011
Mailing Address - Country:US
Mailing Address - Phone:631-754-3172
Mailing Address - Fax:631-239-1447
Practice Address - Street 1:8 HENDRIE LN
Practice Address - Street 2:
Practice Address - City:GREENLAWN
Practice Address - State:NY
Practice Address - Zip Code:11740-1011
Practice Address - Country:US
Practice Address - Phone:631-754-3172
Practice Address - Fax:631-239-1447
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079451-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical