Provider Demographics
NPI:1467066670
Name:LEHR, GINA
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:LEHR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15925 71ST AVE APT 1J
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-3003
Mailing Address - Country:US
Mailing Address - Phone:718-316-7679
Mailing Address - Fax:
Practice Address - Street 1:2012 31ST ST APT 2I
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-2573
Practice Address - Country:US
Practice Address - Phone:718-316-7679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP104064101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health