Provider Demographics
NPI:1881688281
Name:DAVIDOFF, GAIL (LCSW)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:DAVIDOFF
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 1:1420 LOCUST ST
Mailing Address - Street 2:#28Q
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-4223
Mailing Address - Country:US
Mailing Address - Phone:215-735-4232
Mailing Address - Fax:
Practice Address - Street 1:1420 LOCUST ST
Practice Address - Street 2:#28Q
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-4223
Practice Address - Country:US
Practice Address - Phone:215-735-4232
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW000231E1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA638952Medicare ID - Type UnspecifiedSOCIAL WORKER