Provider Demographics
NPI:1730488701
Name:COLON, GILBERT (LCSW)
Entity Type:Individual
Prefix:MR
First Name:GILBERT
Middle Name:
Last Name:COLON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 ELDERT LN
Mailing Address - Street 2:APARTMENT 10U
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-4753
Mailing Address - Country:US
Mailing Address - Phone:718-647-7175
Mailing Address - Fax:
Practice Address - Street 1:790 ELDERT LN
Practice Address - Street 2:APARTMENT 10U
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-4753
Practice Address - Country:US
Practice Address - Phone:718-647-7175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR048721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical