Provider Demographics
NPI:1609366541
Name:SYNERGY BEHAVIORAL HEALTH GROUP
Entity Type:Organization
Organization Name:SYNERGY BEHAVIORAL HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:GAESTEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:302-703-2276
Mailing Address - Street 1:PO BOX 171
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:DE
Mailing Address - Zip Code:19968-0171
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:414 E SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1133
Practice Address - Country:US
Practice Address - Phone:302-703-2276
Practice Address - Fax:302-703-2913
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SYNERGY BEHAVIORAL HEALTH GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE20146007231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty