Provider Demographics
NPI:1417914391
Name:SINCLAIR, GARY (LCSW, CADAC)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:SINCLAIR
Suffix:
Gender:M
Credentials:LCSW, CADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HARRISON EATON LN
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-5314
Mailing Address - Country:US
Mailing Address - Phone:978-337-4749
Mailing Address - Fax:
Practice Address - Street 1:5 MAIN ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:TOPSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01983-1803
Practice Address - Country:US
Practice Address - Phone:978-887-6512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA201105101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional