Provider Demographics
NPI:1326738238
Name:SOMMER-GILLESPIE, PATRICIA (LMSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:SOMMER-GILLESPIE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:SOMMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:340 E 93RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5547
Mailing Address - Country:US
Mailing Address - Phone:917-721-6644
Mailing Address - Fax:
Practice Address - Street 1:14 HARWOOD CT
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-4121
Practice Address - Country:US
Practice Address - Phone:917-721-6644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118001-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker