Provider Demographics
NPI:1841569449
Name:MARQUEZ, GAIL MARIE (LMHC, LPC)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:MARIE
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-5238
Mailing Address - Country:US
Mailing Address - Phone:203-629-2822
Mailing Address - Fax:
Practice Address - Street 1:20 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-5238
Practice Address - Country:US
Practice Address - Phone:203-629-2822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005788101YM0800X
CT002825101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004172912Medicaid