Provider Demographics
NPI:1710118120
Name:NASS, GAIL S (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:S
Last Name:NASS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 CONLAN BLVD NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-3502
Mailing Address - Country:US
Mailing Address - Phone:321-723-8823
Mailing Address - Fax:
Practice Address - Street 1:1501 CONLAN BLVD NE
Practice Address - Street 2:SUITE 200
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-3502
Practice Address - Country:US
Practice Address - Phone:321-723-8823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-03
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9780101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health