Provider Demographics
NPI:1306386503
Name:TRIPODO, GINA (LCSW-R)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:TRIPODO
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MEMORIAL HWY APT 10I
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-8322
Mailing Address - Country:US
Mailing Address - Phone:516-670-5505
Mailing Address - Fax:
Practice Address - Street 1:40 MEMORIAL HWY APT 10I
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-8322
Practice Address - Country:US
Practice Address - Phone:516-670-5505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-07
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0873661041C0700X, 1041S0200X
NYR-0873661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool