Provider Demographics
NPI:1437520236
Name:GELB, MIMI (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MIMI
Middle Name:
Last Name:GELB
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WHEATSTONE RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-2515
Mailing Address - Country:US
Mailing Address - Phone:845-548-8838
Mailing Address - Fax:845-639-9473
Practice Address - Street 1:20 SQUADRON BLVD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5200
Practice Address - Country:US
Practice Address - Phone:845-548-8838
Practice Address - Fax:845-639-9473
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001209-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist