Provider Demographics
NPI:1437275302
Name:GASKIN-LANIYAN, NICOLE D (PHD, LICSW, LCSW-C)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:D
Last Name:GASKIN-LANIYAN
Suffix:
Gender:F
Credentials:PHD, LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4663 QUEENS GROVE ST
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-3481
Mailing Address - Country:US
Mailing Address - Phone:202-431-4373
Mailing Address - Fax:
Practice Address - Street 1:530 7TH ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2768
Practice Address - Country:US
Practice Address - Phone:202-431-4373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500777341041C0700X
MD117571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical