Provider Demographics
NPI:1851673727
Name:KOLODNY, GILA (MHC, LSP)
Entity Type:Individual
Prefix:MRS
First Name:GILA
Middle Name:
Last Name:KOLODNY
Suffix:
Gender:F
Credentials:MHC, LSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6959 136TH ST
Mailing Address - Street 2:1A
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1955
Mailing Address - Country:US
Mailing Address - Phone:646-591-1105
Mailing Address - Fax:
Practice Address - Street 1:10815 LAKE WYNDS CT
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3238
Practice Address - Country:US
Practice Address - Phone:646-591-1105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP73713101YM0800X
FLSS1455103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health