Provider Demographics
NPI:1457843906
Name:TOVAR-GJECKA, EMMA E (LCSW)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:E
Last Name:TOVAR-GJECKA
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 1:12602 82ND AVE
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-1225
Mailing Address - Country:US
Mailing Address - Phone:187-575-4545
Mailing Address - Fax:
Practice Address - Street 1:12602 82ND AVE
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-1225
Practice Address - Country:US
Practice Address - Phone:718-575-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical