Provider Demographics
NPI:1659574036
Name:GIBLIN, ROSEMARY ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:ANN
Last Name:GIBLIN
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 1:6 CEDAR DRIVE EAST
Mailing Address - Street 2:
Mailing Address - City:OLD BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11804-0000
Mailing Address - Country:US
Mailing Address - Phone:516-293-9844
Mailing Address - Fax:516-293-9844
Practice Address - Street 1:6 CEDAR DRIVE EAST
Practice Address - Street 2:
Practice Address - City:OLD BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11804-0000
Practice Address - Country:US
Practice Address - Phone:516-293-9844
Practice Address - Fax:516-293-9844
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR01288711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02310176Medicaid
NY02310176Medicaid