Provider Demographics
NPI:1528404605
Name:NEISH, GAIL LYNN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:LYNN
Last Name:NEISH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17
Mailing Address - Street 2:
Mailing Address - City:CONNELLY
Mailing Address - State:NY
Mailing Address - Zip Code:12417-0017
Mailing Address - Country:US
Mailing Address - Phone:845-802-0006
Mailing Address - Fax:
Practice Address - Street 1:239 GOLDEN HILL LN
Practice Address - Street 2:100
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-6441
Practice Address - Country:US
Practice Address - Phone:845-871-1182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0753391104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker