Provider Demographics
NPI:1790851533
Name:ALWILL, GALE ANN (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:GALE
Middle Name:ANN
Last Name:ALWILL
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 1:262 W MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08805-1333
Mailing Address - Country:US
Mailing Address - Phone:646-739-9580
Mailing Address - Fax:
Practice Address - Street 1:402 MAIN ST STE 214
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-1846
Practice Address - Country:US
Practice Address - Phone:917-699-8939
Practice Address - Fax:848-260-0772
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-0594631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN468X1Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER