Provider Demographics
NPI:1851459507
Name:NEVELS, GAIL FOSTER
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:FOSTER
Last Name:NEVELS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:FOSTER
Other - Last Name:NEVELS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LISW
Mailing Address - Street 1:2000 HARVARD ROAD
Mailing Address - Street 2:SOUTH POINTE HOSPITAL 212
Mailing Address - City:WARRENSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-591-6529
Mailing Address - Fax:
Practice Address - Street 1:2000 HARVARD ROAD
Practice Address - Street 2:SOUTH POINTE HOSPITAL 212
Practice Address - City:WARRENSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-591-6529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-55621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical