Provider Demographics
NPI:1417234949
Name:GAYLE, KAYMARA (LCSW)
Entity Type:Individual
Prefix:
First Name:KAYMARA
Middle Name:
Last Name:GAYLE
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 1:800 POLY PLACE
Mailing Address - Street 2:DEPARTMENT VETERANS AFFAIRS
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209
Mailing Address - Country:US
Mailing Address - Phone:646-348-0440
Mailing Address - Fax:
Practice Address - Street 1:800 POLY PLACE
Practice Address - Street 2:DEPARTMENT OF VETERAN
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209
Practice Address - Country:US
Practice Address - Phone:646-348-0440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-11
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0825461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical