Provider Demographics
NPI:1386686871
Name:NUNZIATO-SMITH, GINA ANN (LMSW)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:ANN
Last Name:NUNZIATO-SMITH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:ANN
Other - Last Name:NUNZIATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:21A UPTON RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-1821
Mailing Address - Country:US
Mailing Address - Phone:518-489-2500
Mailing Address - Fax:
Practice Address - Street 1:113 HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3410
Practice Address - Country:US
Practice Address - Phone:518-626-6096
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069905-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker