Provider Demographics
NPI:1659582021
Name:GENTILE, MARGUERITE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARGUERITE
Middle Name:
Last Name:GENTILE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARGUERITE
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:130 BEAR PATH RD
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-1329
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:475-238-7931
Practice Address - Street 1:130 BEAR PATH RD
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-1329
Practice Address - Country:US
Practice Address - Phone:475-238-7931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0073431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical