Provider Demographics
NPI:1821867839
Name:HALPERIN-GOLDSTEIN, GABRIEL (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:HALPERIN-GOLDSTEIN
Suffix:
Gender:M
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-3309
Mailing Address - Country:US
Mailing Address - Phone:781-879-4784
Mailing Address - Fax:
Practice Address - Street 1:345 MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-2801
Practice Address - Country:US
Practice Address - Phone:866-532-7669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health