Provider Demographics
NPI:1326327560
Name:MARIOTTI, GABRIELE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:GABRIELE
Middle Name:
Last Name:MARIOTTI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 EAST 40TH STREET
Mailing Address - Street 2:SUITE 801
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0401
Mailing Address - Country:US
Mailing Address - Phone:845-731-9621
Mailing Address - Fax:646-619-4787
Practice Address - Street 1:15 EAST 40TH STREET
Practice Address - Street 2:SUITE 801
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0401
Practice Address - Country:US
Practice Address - Phone:845-731-9621
Practice Address - Fax:646-619-4787
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-05
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0827741041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical