Provider Demographics
NPI:1982188835
Name:NINA GILBERT PSYCHOTHERAPY, LLC
Entity Type:Organization
Organization Name:NINA GILBERT PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-281-3411
Mailing Address - Street 1:120 DWIGHT ST APT 103
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-4543
Mailing Address - Country:US
Mailing Address - Phone:704-281-3411
Mailing Address - Fax:475-202-6527
Practice Address - Street 1:79 TRUMBULL ST STE C9
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3708
Practice Address - Country:US
Practice Address - Phone:203-535-1430
Practice Address - Fax:475-202-6527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health