Provider Demographics
NPI:1891722591
Name:LEWIN, GLORIA PLATO (CRC, LMHC)
Entity Type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:PLATO
Last Name:LEWIN
Suffix:
Gender:F
Credentials:CRC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8411A SHALLOWCREEK RD
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-1327
Mailing Address - Country:US
Mailing Address - Phone:315-652-4656
Mailing Address - Fax:
Practice Address - Street 1:1031 E FAYETTE ST
Practice Address - Street 2:VA COMMUNITY CARE CENTER
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1022
Practice Address - Country:US
Practice Address - Phone:315-425-4445
Practice Address - Fax:315-425-4406
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000329101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional